Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $750.00 / $1,508.00 / $4,396.00	Facility		$750.00	$1,508.00	$4,396.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $29.12 / $29.12 / $98.85	Facility	52	$29.12	$29.12	$98.85
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $11.65 / $11.65 / $39.54	Facility	53	$11.65	$11.65	$39.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.93 / $129.75 / $319.25	Professional		$55.93	$129.75	$319.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.64 / $43.28 / $149.46	Professional		$21.64	$43.28	$149.46
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 $53.72 / $111.20 / $285.76	Professional		$53.72	$111.20	$285.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $156.55 / $204.38 / $218.55	Facility		$156.55	$204.38	$218.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.05 / $123.99 / $286.66	Professional		$59.05	$123.99	$286.66
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $47.82 / $129.74 / $322.43	Professional		$47.82	$129.74	$322.43
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $193.14 / $1,007.60 / $1,007.60	Facility		$193.14	$1,007.60	$1,007.60
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $53.13 / $79.70 / $289.70	Professional		$53.13	$79.70	$289.70
United Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $1,514.00 / $4,661.00	Facility		$408.00	$1,514.00	$4,661.00
United Facility/Professional Professional Modifier Low / Median / High Price $129.47 / $189.00 / $313.75	Professional		$129.47	$189.00	$313.75