Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $344.30 / $2,173.00 / $4,730.00	Facility		$344.30	$2,173.00	$4,730.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $156.28 / $253.38 / $482.33	Professional		$156.28	$253.38	$482.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.63 / $177.63 / $177.63	Professional		$177.63	$177.63	$177.63
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 $153.60 / $254.03 / $491.90	Professional		$153.60	$254.03	$491.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $665.97 / $869.42 / $929.73	Facility		$665.97	$869.42	$929.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.46 / $267.93 / $501.50	Professional		$159.46	$267.93	$501.50
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $127.75 / $296.30 / $685.78	Professional		$127.75	$296.30	$685.78
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $685.78 / $1,303.09 / $1,303.09	Facility		$685.78	$1,303.09	$1,303.09
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $163.04 / $256.91 / $546.78	Professional		$163.04	$256.91	$546.78
United Facility/Professional Facility Modifier Low / Median / High Price $548.60 / $1,967.00 / $3,658.00	Facility		$548.60	$1,967.00	$3,658.00
United Facility/Professional Professional Modifier Low / Median / High Price $229.14 / $322.27 / $527.95	Professional		$229.14	$322.27	$527.95