Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.61 / $1,706.00 / $4,473.00	Facility		$147.61	$1,706.00	$4,473.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $88.70 / $97.47 / $110.71	Facility	54	$88.70	$97.47	$110.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.84 / $132.96 / $604.00	Professional		$113.84	$132.96	$604.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.84 / $115.84 / $115.84	Professional		$115.84	$115.84	$115.84
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 $115.99 / $133.40 / $207.49	Professional		$115.99	$133.40	$207.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.52 / $106.52 / $106.52	Facility		$106.52	$106.52	$106.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.20 / $162.37 / $243.56	Professional		$117.20	$162.37	$243.56
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.06 / $157.69 / $241.46	Professional		$1.06	$157.69	$241.46
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 $0.72 / $143.46 / $236.73	Professional		$0.72	$143.46	$236.73
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 $120.84 / $156.68 / $245.71	Professional		$120.84	$156.68	$245.71