Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $299.62 / $2,173.00 / $4,841.00	Facility		$299.62	$2,173.00	$4,841.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $156.65 / $186.42 / $224.72	Facility	54	$156.65	$186.42	$224.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $243.49 / $296.17 / $832.00	Professional		$243.49	$296.17	$832.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $416.31 / $416.31 / $587.26	Professional	50	$416.31	$416.31	$587.26
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $166.01 / $203.81 / $873.93	Professional	54	$166.01	$203.81	$873.93
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $33.20 / $40.15 / $48.96	Professional	55	$33.20	$40.15	$48.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.00 / $234.00 / $381.15	Professional		$234.00	$234.00	$381.15
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 $208.87 / $264.64 / $344.28	Professional		$208.87	$264.64	$344.28
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $299.60 / $352.47 / $391.63	Professional	50	$299.60	$352.47	$391.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $137.49 / $137.49 / $137.49	Facility		$137.49	$137.49	$137.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.20 / $302.14 / $627.04	Professional		$240.20	$302.14	$627.04
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $132.49 / $257.62 / $408.16	Professional		$132.49	$257.62	$408.16
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $606.29 / $606.29 / $606.29	Facility		$606.29	$606.29	$606.29
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $170.19 / $220.82 / $255.29	Professional		$170.19	$220.82	$255.29
United Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $1,917.00 / $4,661.00	Facility		$408.00	$1,917.00	$4,661.00
United Facility/Professional Professional Modifier Low / Median / High Price $163.98 / $335.23 / $1,115.00	Professional		$163.98	$335.23	$1,115.00