Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $816.00 / $1,937.00 / $4,396.00	Facility		$816.00	$1,937.00	$4,396.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $92.27 / $92.27 / $205.95	Facility	52	$92.27	$92.27	$205.95
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $36.90 / $36.90 / $82.38	Facility	53	$36.90	$36.90	$82.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.37 / $267.07 / $651.58	Professional		$173.37	$267.07	$651.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.71 / $98.71 / $149.30	Professional		$98.71	$98.71	$149.30
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 $194.89 / $313.01 / $637.42	Professional		$194.89	$313.01	$637.42
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 $173.99 / $286.02 / $617.85	Professional		$173.99	$286.02	$617.85
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $100.91 / $271.67 / $679.55	Professional		$100.91	$271.67	$679.55
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 $155.24 / $232.86 / $637.08	Professional		$155.24	$232.86	$637.08
United Facility/Professional Facility Modifier Low / Median / High Price $721.00 / $2,200.00 / $3,658.00	Facility		$721.00	$2,200.00	$3,658.00
United Facility/Professional Professional Modifier Low / Median / High Price $201.14 / $380.52 / $655.35	Professional		$201.14	$380.52	$655.35