Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $1,862.09 / $5,011.87	Facility		$112.20	$1,862.09	$5,011.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $128.82 / $323.59	Professional		$112.20	$128.82	$323.59
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $114.82 / $147.91 / $229.09	Professional	54	$114.82	$147.91	$229.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $125.89 / $181.97	Professional		$97.72	$125.89	$181.97
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $69.18 / $69.18 / $69.18	Professional	54	$69.18	$69.18	$69.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $3,467.37 / $4,466.84	Facility		$1,513.56	$3,467.37	$4,466.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $141.25 / $223.87	Professional		$112.20	$141.25	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Facility		$85.11	$85.11	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $147.91 / $213.80	Professional		$112.20	$147.91	$213.80
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.72 / $141.25 / $213.80	Professional		$0.72	$141.25	$213.80
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $186.21 / $194.98	Professional		$138.04	$186.21	$194.98
Select Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $128.82 / $229.09	Professional		$123.03	$128.82	$229.09
United Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $1,288.25 / $2,041.74	Facility		$199.53	$1,288.25	$2,041.74
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $131.83 / $208.93	Professional		$100.00	$131.83	$208.93