Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $601.25 / $1,989.00 / $4,396.00	Facility		$601.25	$1,989.00	$4,396.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $71.75 / $71.75 / $203.08	Facility	52	$71.75	$71.75	$203.08
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $28.70 / $28.70 / $81.23	Facility	53	$28.70	$28.70	$81.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.72 / $242.88 / $740.83	Professional		$132.72	$242.88	$740.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $119.35 / $119.35 / $279.18	Professional		$119.35	$119.35	$279.18
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 $153.13 / $308.73 / $586.15	Professional		$153.13	$308.73	$586.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $529.64 / $580.00 / $739.41	Facility		$529.64	$580.00	$739.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.15 / $302.23 / $593.63	Professional		$146.15	$302.23	$593.63
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $116.00 / $320.39 / $659.92	Professional		$116.00	$320.39	$659.92
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 $122.11 / $183.17 / $626.51	Professional		$122.11	$183.17	$626.51
United Facility/Professional Facility Modifier Low / Median / High Price $721.00 / $1,967.00 / $6,244.00	Facility		$721.00	$1,967.00	$6,244.00
United Facility/Professional Professional Modifier Low / Median / High Price $319.68 / $414.57 / $675.86	Professional		$319.68	$414.57	$675.86