Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $504.17 / $1,639.00 / $4,396.00	Facility		$504.17	$1,639.00	$4,396.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $311.02 / $341.79 / $378.13	Facility	54	$311.02	$341.79	$378.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.39 / $455.72 / $1,122.66	Professional		$400.39	$455.72	$1,122.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,072.00 / $3,931.00 / $5,258.00	Facility		$3,072.00	$3,931.00	$5,258.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $480.92 / $514.88 / $707.96	Professional		$480.92	$514.88	$707.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $882.01 / $882.01 / $882.01	Facility		$882.01	$882.01	$882.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $394.53 / $583.53 / $820.29	Professional		$394.53	$583.53	$820.29
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.41 / $594.04 / $973.51	Professional		$4.41	$594.04	$973.51
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $1,768.74 / $1,768.74 / $1,768.74	Facility		$1,768.74	$1,768.74	$1,768.74
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $475.27 / $1,367.18	Professional		$3.00	$475.27	$1,367.18
United Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $1,925.00 / $4,715.00	Facility		$408.00	$1,925.00	$4,715.00
United Facility/Professional Professional Modifier Low / Median / High Price $418.77 / $551.16 / $849.27	Professional		$418.77	$551.16	$849.27