Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $750.00 / $1,639.00 / $8,102.72	Facility		$750.00	$1,639.00	$8,102.72
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $28.34 / $31.21 / $76.38	Facility	53	$28.34	$31.21	$76.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.69 / $293.67 / $1,055.00	Professional		$141.69	$293.67	$1,055.00
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 $168.29 / $297.69 / $553.96	Professional		$168.29	$297.69	$553.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,761.57 / $1,761.57 / $1,761.57	Facility		$1,761.57	$1,761.57	$1,761.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.74 / $244.00 / $495.41	Professional		$160.74	$244.00	$495.41
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $125.52 / $309.42 / $1,814.89	Professional		$125.52	$309.42	$1,814.89
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $1,814.89 / $3,513.95 / $3,513.95	Facility		$1,814.89	$3,513.95	$3,513.95
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $132.13 / $145.44 / $488.57	Professional		$132.13	$145.44	$488.57
United Facility/Professional Facility Modifier Low / Median / High Price $1,282.00 / $2,947.00 / $7,138.00	Facility		$1,282.00	$2,947.00	$7,138.00
United Facility/Professional Professional Modifier Low / Median / High Price $217.22 / $359.78 / $564.85	Professional		$217.22	$359.78	$564.85