Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $678.50 / $1,639.00 / $4,396.00	Facility		$678.50	$1,639.00	$4,396.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,068.75 / $1,068.75 / $1,068.75	Facility	50	$1,068.75	$1,068.75	$1,068.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.37 / $197.18 / $789.93	Professional		$62.37	$197.18	$789.93
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $93.56 / $161.93 / $302.07	Professional	50	$93.56	$161.93	$302.07
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 $74.29 / $84.68 / $120.77	Professional		$74.29	$84.68	$120.77
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $125.19 / $130.97 / $407.02	Professional	50	$125.19	$130.97	$407.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.51 / $187.81 / $396.35	Professional		$69.51	$187.81	$396.35
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.92 / $95.39 / $383.17	Professional		$1.92	$95.39	$383.17
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.44 / $85.68 / $399.14	Professional		$1.44	$85.68	$399.14
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 $177.28 / $276.97 / $402.38	Professional		$177.28	$276.97	$402.38