Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $289.91 / $1,639.00 / $4,396.00	Facility		$289.91	$1,639.00	$4,396.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $822.32 / $822.32 / $822.32	Facility	50	$822.32	$822.32	$822.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.94 / $87.03 / $474.05	Professional		$46.94	$87.03	$474.05
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $70.41 / $148.52 / $430.14	Professional	50	$70.41	$148.52	$430.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $333.00 / $333.00 / $333.00	Facility		$333.00	$333.00	$333.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.90 / $56.91 / $86.94	Professional		$46.90	$56.91	$86.94
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $94.78 / $99.39 / $133.18	Professional	50	$94.78	$99.39	$133.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.30 / $84.76 / $142.24	Professional		$53.30	$84.76	$142.24
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.60 / $70.11 / $150.84	Professional		$1.60	$70.11	$150.84
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.20 / $64.98 / $143.21	Professional		$1.20	$64.98	$143.21
United Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $1,427.00 / $1,998.00	Facility		$200.00	$1,427.00	$1,998.00
United Facility/Professional Professional Modifier Low / Median / High Price $83.49 / $115.52 / $166.99	Professional		$83.49	$115.52	$166.99