Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $365.10 / $1,706.00 / $4,473.00	Facility		$365.10	$1,706.00	$4,473.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $180.28 / $214.52 / $273.83	Facility	54	$180.28	$214.52	$273.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.37 / $290.12 / $512.94	Professional		$240.37	$290.12	$512.94
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $341.79 / $508.50 / $2,704.50	Professional	50	$341.79	$508.50	$2,704.50
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $182.85 / $224.76 / $290.52	Professional	54	$182.85	$224.76	$290.52
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $36.57 / $44.95 / $58.10	Professional	55	$36.57	$44.95	$58.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $224.94 / $283.81 / $436.42	Professional		$224.94	$283.81	$436.42
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $425.72 / $425.72 / $425.72	Professional	50	$425.72	$425.72	$425.72
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 $244.94 / $311.45 / $397.02	Professional		$244.94	$311.45	$397.02
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $367.41 / $432.25 / $480.28	Professional	50	$367.41	$432.25	$480.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $189.90 / $189.90 / $189.90	Facility		$189.90	$189.90	$189.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.37 / $327.35 / $577.97	Professional		$240.37	$327.35	$577.97
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $180.86 / $298.24 / $498.06	Professional		$180.86	$298.24	$498.06
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 $200.95 / $283.81 / $305.48	Professional		$200.95	$283.81	$305.48
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 $288.66 / $377.00 / $575.65	Professional		$288.66	$377.00	$575.65