Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.75 / $1,639.00 / $4,473.00	Facility		$89.75	$1,639.00	$4,473.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $769.13 / $769.13 / $769.13	Facility	50	$769.13	$769.13	$769.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.57 / $80.40 / $276.39	Professional		$47.57	$80.40	$276.39
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $77.56 / $236.96 / $403.76	Professional	50	$77.56	$236.96	$403.76
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 $47.92 / $58.15 / $88.09	Professional		$47.92	$58.15	$88.09
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $96.73 / $101.34 / $134.94	Professional	50	$96.73	$101.34	$134.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.99 / $85.87 / $141.72	Professional		$53.99	$85.87	$141.72
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.60 / $70.55 / $155.60	Professional		$1.60	$70.55	$155.60
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.20 / $66.98 / $147.72	Professional		$1.20	$66.98	$147.72
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 / $111.59 / $159.40	Professional		$83.49	$111.59	$159.40