Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $2,187.76 / $4,786.30	Facility		$912.01	$2,187.76	$4,786.30
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Facility	52	$1,513.56	$1,513.56	$1,513.56
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $95.50 / $95.50 / $181.97	Facility	53	$95.50	$95.50	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $346.74 / $1,047.13	Professional		$181.97	$346.74	$1,047.13
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $77.62 / $144.54 / $389.05	Professional	53	$77.62	$144.54	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $177.83 / $316.23	Professional		$154.88	$177.83	$316.23
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $43.65 / $87.10 / $107.15	Professional	53	$43.65	$87.10	$107.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $3,467.37 / $4,466.84	Facility		$1,513.56	$3,467.37	$4,466.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $251.19 / $407.38	Professional		$165.96	$251.19	$407.38
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $79.43 / $125.89 / $190.55	Professional	53	$79.43	$125.89	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $524.81 / $724.44	Facility		$512.86	$524.81	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $338.84 / $630.96	Professional		$194.98	$338.84	$630.96
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $75.86 / $107.15 / $269.15	Professional	53	$75.86	$107.15	$269.15
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $380.19 / $630.96	Professional		$154.88	$380.19	$630.96
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $537.03 / $537.03	Facility		$537.03	$537.03	$537.03
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $562.34 / $794.33	Professional		$245.47	$562.34	$794.33
Select Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $380.19 / $676.08	Professional		$162.18	$380.19	$676.08
Select Health Facility/Professional Professional Modifier 53 Low / Median / High Price $109.65 / $251.19 / $457.09	Professional	53	$109.65	$251.19	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,949.84 / $6,309.57	Facility		$724.44	$1,949.84	$6,309.57
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $331.13 / $562.34	Professional		$186.21	$331.13	$562.34