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 50 Low / Median / High Price $1,742.79 / $1,742.79 / $1,742.79	Facility	50	$1,742.79	$1,742.79	$1,742.79
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $56.96 / $59.80 / $176.99	Facility	52	$56.96	$59.80	$176.99
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $22.78 / $23.92 / $70.79	Facility	53	$22.78	$23.92	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.65 / $337.12 / $768.08	Professional		$96.65	$337.12	$768.08
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 $120.01 / $316.45 / $796.41	Professional		$120.01	$316.45	$796.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $349.64 / $349.64 / $349.64	Facility		$349.64	$349.64	$349.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.58 / $336.64 / $708.99	Professional		$92.58	$336.64	$708.99
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $86.75 / $309.97 / $629.66	Professional		$86.75	$309.97	$629.66
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $359.81 / $683.29 / $683.29	Facility		$359.81	$683.29	$683.29
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $92.64 / $102.77 / $464.96	Professional		$92.64	$102.77	$464.96
United Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $1,925.00 / $4,715.00	Facility		$408.00	$1,925.00	$4,715.00
United Facility/Professional Professional Modifier Low / Median / High Price $318.60 / $506.27 / $998.40	Professional		$318.60	$506.27	$998.40