Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $276.18 / $2,173.00 / $4,841.00	Facility		$276.18	$2,173.00	$4,841.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,967.00 / $2,967.00 / $2,967.00	Facility	50	$2,967.00	$2,967.00	$2,967.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.78 / $263.02 / $868.01	Professional		$174.78	$263.02	$868.01
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,387.31 / $1,890.48 / $1,890.48	Professional	50	$1,387.31	$1,890.48	$1,890.48
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 $185.72 / $282.38 / $431.80	Professional		$185.72	$282.38	$431.80
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $311.06 / $365.95 / $406.62	Professional	50	$311.06	$365.95	$406.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $833.45 / $833.45 / $833.45	Facility		$833.45	$833.45	$833.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.19 / $284.64 / $402.14	Professional		$166.19	$284.64	$402.14
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $135.05 / $296.91 / $881.06	Professional		$135.05	$296.91	$881.06
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $881.06 / $1,905.85 / $1,905.85	Facility		$881.06	$1,905.85	$1,905.85
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $142.16 / $160.72 / $387.27	Professional		$142.16	$160.72	$387.27
United Facility/Professional Facility Modifier Low / Median / High Price $721.00 / $2,200.00 / $6,244.00	Facility		$721.00	$2,200.00	$6,244.00
United Facility/Professional Professional Modifier Low / Median / High Price $255.96 / $346.90 / $483.49	Professional		$255.96	$346.90	$483.49