Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.72 / $1,639.00 / $4,396.00	Facility		$281.72	$1,639.00	$4,396.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $45.87 / $45.87 / $140.86	Facility	52	$45.87	$45.87	$140.86
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $18.35 / $18.35 / $56.34	Facility	53	$18.35	$18.35	$56.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.92 / $192.56 / $375.21	Professional		$88.92	$192.56	$375.21
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 $97.41 / $205.31 / $406.22	Professional		$97.41	$205.31	$406.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $529.64 / $691.45 / $739.41	Facility		$529.64	$691.45	$739.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.14 / $222.81 / $422.58	Professional		$92.14	$222.81	$422.58
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $70.52 / $214.49 / $545.84	Professional		$70.52	$214.49	$545.84
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $519.85 / $1,036.17 / $1,036.17	Facility		$519.85	$1,036.17	$1,036.17
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $78.34 / $117.53 / $428.97	Professional		$78.34	$117.53	$428.97
United Facility/Professional Facility Modifier Low / Median / High Price $721.00 / $1,891.00 / $6,244.00	Facility		$721.00	$1,891.00	$6,244.00
United Facility/Professional Professional Modifier Low / Median / High Price $202.95 / $275.60 / $444.50	Professional		$202.95	$275.60	$444.50