Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $750.00 / $1,639.00 / $4,396.00	Facility		$750.00	$1,639.00	$4,396.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $147.19 / $156.41 / $171.87	Facility	54	$147.19	$156.41	$171.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.61 / $208.54 / $947.00	Professional		$175.61	$208.54	$947.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $146.56 / $157.82 / $817.59	Professional	54	$146.56	$157.82	$817.59
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 $181.26 / $206.80 / $339.29	Professional		$181.26	$206.80	$339.29
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 $177.26 / $262.69 / $381.32	Professional		$177.26	$262.69	$381.32
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.12 / $235.69 / $372.39	Professional		$2.12	$235.69	$372.39
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 $1.44 / $212.30 / $353.54	Professional		$1.44	$212.30	$353.54
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 $180.74 / $246.85 / $394.38	Professional		$180.74	$246.85	$394.38