Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.70 / $1,639.00 / $4,473.00	Facility		$106.70	$1,639.00	$4,473.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $30.13 / $33.17 / $53.35	Facility	52	$30.13	$33.17	$53.35
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $12.05 / $13.27 / $21.34	Facility	53	$12.05	$13.27	$21.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.34 / $112.43 / $515.67	Professional		$66.34	$112.43	$515.67
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.13 / $43.76 / $181.84	Professional	52	$30.13	$43.76	$181.84
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $12.05 / $19.38 / $103.14	Professional	53	$12.05	$19.38	$103.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,779.00 / $3,647.00 / $4,098.00	Facility		$2,779.00	$3,647.00	$4,098.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.25 / $116.34 / $161.02	Professional		$71.25	$116.34	$161.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.45 / $54.45 / $54.45	Facility		$54.45	$54.45	$54.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.30 / $101.55 / $163.32	Professional		$74.30	$101.55	$163.32
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $48.90 / $93.19 / $163.90	Professional		$48.90	$93.19	$163.90
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $54.33 / $222.33 / $222.33	Facility		$54.33	$222.33	$222.33
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $53.95 / $60.13 / $96.35	Professional		$53.95	$60.13	$96.35
United Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $1,427.00 / $1,998.00	Facility		$200.00	$1,427.00	$1,998.00
United Facility/Professional Professional Modifier Low / Median / High Price $98.00 / $129.03 / $181.12	Professional		$98.00	$129.03	$181.12