Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.81 / $1,706.00 / $4,473.00	Facility		$140.81	$1,706.00	$4,473.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $810.45 / $810.45 / $810.45	Facility	50	$810.45	$810.45	$810.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.89 / $116.74 / $553.03	Professional		$95.89	$116.74	$553.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $162.54 / $684.75 / $855.00	Professional	50	$162.54	$684.75	$855.00
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 $107.53 / $123.72 / $190.57	Professional		$107.53	$123.72	$190.57
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $141.46 / $220.32 / $264.12	Professional	50	$141.46	$220.32	$264.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.83 / $72.83 / $72.83	Facility		$72.83	$72.83	$72.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.88 / $148.22 / $226.78	Professional		$99.88	$148.22	$226.78
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.92 / $125.81 / $206.98	Professional		$1.92	$125.81	$206.98
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $326.24 / $326.24 / $326.24	Facility		$326.24	$326.24	$326.24
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.44 / $121.98 / $211.88	Professional		$1.44	$121.98	$211.88
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 $117.18 / $160.44 / $248.59	Professional		$117.18	$160.44	$248.59