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 / $4,396.00	Facility		$750.00	$1,639.00	$4,396.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $901.25 / $901.25 / $1,617.00	Facility	50	$901.25	$901.25	$1,617.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.64 / $96.02 / $185.65	Professional		$53.64	$96.02	$185.65
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 $60.90 / $71.53 / $95.00	Professional		$60.90	$71.53	$95.00
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $107.39 / $132.03 / $172.51	Professional	50	$107.39	$132.03	$172.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $502.86 / $502.86 / $502.86	Facility		$502.86	$502.86	$502.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.36 / $117.34 / $202.46	Professional		$68.36	$117.34	$202.46
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.32 / $95.31 / $493.00	Professional		$1.32	$95.31	$493.00
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $983.93 / $983.93 / $983.93	Facility		$983.93	$983.93	$983.93
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.90 / $72.23 / $760.46	Professional		$0.90	$72.23	$760.46
United Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $1,917.00 / $4,715.00	Facility		$408.00	$1,917.00	$4,715.00
United Facility/Professional Professional Modifier Low / Median / High Price $85.71 / $147.30 / $218.50	Professional		$85.71	$147.30	$218.50