Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $721.50 / $1,639.00 / $4,396.00	Facility		$721.50	$1,639.00	$4,396.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.22 / $19.63 / $51.85	Facility	53	$19.22	$19.63	$51.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.34 / $227.44 / $623.41	Professional		$91.34	$227.44	$623.41
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 $102.44 / $138.99 / $192.04	Professional		$102.44	$138.99	$192.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $391.14 / $391.14 / $391.14	Facility		$391.14	$391.14	$391.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.75 / $213.60 / $409.34	Professional		$102.75	$213.60	$409.34
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.20 / $167.49 / $471.39	Professional		$1.20	$167.49	$471.39
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $765.36 / $765.36 / $765.36	Facility		$765.36	$765.36	$765.36
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.90 / $132.38 / $606.89	Professional		$0.90	$132.38	$606.89
United Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $1,925.00 / $4,715.00	Facility		$408.00	$1,925.00	$4,715.00
United Facility/Professional Professional Modifier Low / Median / High Price $218.70 / $313.47 / $584.05	Professional		$218.70	$313.47	$584.05