Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.00 / $1,711.40 / $4,396.00	Facility		$190.00	$1,711.40	$4,396.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,428.68 / $1,428.68 / $2,567.10	Facility	50	$1,428.68	$1,428.68	$2,567.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.34 / $177.69 / $558.16	Professional		$101.34	$177.69	$558.16
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $98.04 / $282.33 / $937.63	Professional	50	$98.04	$282.33	$937.63
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 $96.67 / $117.31 / $179.67	Professional		$96.67	$117.31	$179.67
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $193.48 / $206.40 / $275.17	Professional	50	$193.48	$206.40	$275.17
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 $109.69 / $185.21 / $302.45	Professional		$109.69	$185.21	$302.45
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.40 / $173.63 / $498.75	Professional		$2.40	$173.63	$498.75
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 $1.80 / $139.91 / $760.46	Professional		$1.80	$139.91	$760.46
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 $178.20 / $273.57 / $399.48	Professional		$178.20	$273.57	$399.48