Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $750.00 / $1,713.00 / $4,396.00	Facility		$750.00	$1,713.00	$4,396.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,264.27 / $3,264.27 / $5,568.36	Facility	50	$3,264.27	$3,264.27	$5,568.36
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $21.47 / $21.94 / $49.42	Facility	53	$21.47	$21.94	$49.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.56 / $235.49 / $646.91	Professional		$94.56	$235.49	$646.91
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.52 / $141.52 / $191.19	Professional	22	$141.52	$141.52	$191.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $141.84 / $442.75 / $1,402.63	Professional	50	$141.84	$442.75	$1,402.63
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $21.33 / $42.53 / $118.09	Professional	53	$21.33	$42.53	$118.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $232.96 / $232.96 / $232.96	Professional		$232.96	$232.96	$232.96
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $160.36 / $160.36 / $160.36	Professional	50	$160.36	$160.36	$160.36
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 $93.95 / $114.01 / $194.00	Professional		$93.95	$114.01	$194.00
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $154.11 / $218.13 / $291.00	Professional	50	$154.11	$218.13	$291.00
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 $115.45 / $213.81 / $442.18	Professional		$115.45	$213.81	$442.18
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.76 / $190.00 / $499.19	Professional		$1.76	$190.00	$499.19
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 $1.20 / $147.93 / $760.46	Professional		$1.20	$147.93	$760.46
United Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $1,917.00 / $4,661.00	Facility		$408.00	$1,917.00	$4,661.00
United Facility/Professional Professional Modifier Low / Median / High Price $208.63 / $317.58 / $580.63	Professional		$208.63	$317.58	$580.63