Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $2,137.96 / $5,011.87	Facility		$245.47	$2,137.96	$5,011.87
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,235.94 / $5,623.41 / $5,623.41	Facility	50	$3,235.94	$5,623.41	$5,623.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $251.19 / $1,202.26	Professional		$104.71	$251.19	$1,202.26
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.25 / $190.55 / $1,230.27	Professional	22	$141.25	$190.55	$1,230.27
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $380.19 / $2,089.30	Professional	50	$147.91	$380.19	$2,089.30
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $63.10 / $63.10 / $125.89	Professional	53	$63.10	$63.10	$125.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $109.65 / $245.47	Professional		$91.20	$109.65	$245.47
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $138.04 / $169.82 / $371.54	Professional	50	$138.04	$169.82	$371.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $3,467.37 / $4,466.84	Facility		$1,513.56	$3,467.37	$4,466.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $141.25 / $213.80	Professional		$95.50	$141.25	$213.80
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $144.54 / $218.78 / $288.40	Professional	50	$144.54	$218.78	$288.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Facility		$501.19	$501.19	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $223.87 / $446.68	Professional		$117.49	$223.87	$446.68
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.82 / $257.04 / $457.09	Professional		$1.82	$257.04	$457.09
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $398.11 / $758.58	Professional		$147.91	$398.11	$758.58
Select Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $263.03 / $831.76	Professional		$97.72	$263.03	$831.76
United Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $1,584.89 / $4,786.30	Facility		$407.38	$1,584.89	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $218.78 / $416.87	Professional		$107.15	$218.78	$416.87