Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $222.12 / $1,706.00 / $4,473.00	Facility		$222.12	$1,706.00	$4,473.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $137.19 / $150.76 / $166.59	Facility	54	$137.19	$150.76	$166.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.38 / $199.28 / $433.94	Professional		$176.38	$199.28	$433.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,529.00 / $3,433.00 / $4,098.00	Facility		$1,529.00	$3,433.00	$4,098.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.04 / $202.06 / $318.77	Professional		$182.04	$202.06	$318.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.65 / $135.65 / $135.65	Facility		$135.65	$135.65	$135.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $180.58 / $259.00 / $371.90	Professional		$180.58	$259.00	$371.90
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.29 / $230.06 / $353.70	Professional		$2.29	$230.06	$353.70
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $265.11 / $265.11 / $265.11	Facility		$265.11	$265.11	$265.11
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.56 / $212.30 / $345.09	Professional		$1.56	$212.30	$345.09
United Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $1,427.00 / $1,998.00	Facility		$200.00	$1,427.00	$1,998.00
United Facility/Professional Professional Modifier Low / Median / High Price $187.20 / $247.34 / $382.40	Professional		$187.20	$247.34	$382.40