Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $820.54 / $2,056.00 / $4,730.00	Facility		$820.54	$2,056.00	$4,730.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $96.15 / $181.28 / $1,516.50	Facility	52	$96.15	$181.28	$1,516.50
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.46 / $96.15 / $181.28	Facility	53	$38.46	$96.15	$181.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.05 / $311.97 / $838.29	Professional		$186.05	$311.97	$838.29
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $38.46 / $95.58 / $208.03	Professional	53	$38.46	$95.58	$208.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $175.09 / $218.86 / $304.41	Professional		$175.09	$218.86	$304.41
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $79.94 / $79.94 / $136.30	Professional	53	$79.94	$79.94	$136.30
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 $176.90 / $248.59 / $365.70	Professional		$176.90	$248.59	$365.70
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $74.84 / $163.46 / $192.31	Professional	53	$74.84	$163.46	$192.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $515.00 / $520.00 / $718.96	Facility		$515.00	$520.00	$718.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.31 / $337.78 / $633.00	Professional		$196.31	$337.78	$633.00
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $79.29 / $106.32 / $210.90	Professional	53	$79.29	$106.32	$210.90
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $154.30 / $357.00 / $634.91	Professional		$154.30	$357.00	$634.91
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $533.04 / $1,007.60 / $1,007.60	Facility		$533.04	$1,007.60	$1,007.60
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $162.41 / $243.63 / $564.11	Professional		$162.41	$243.63	$564.11
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 $320.27 / $410.47 / $625.25	Professional		$320.27	$410.47	$625.25