Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $2,238.72 / $5,011.87	Facility		$338.84	$2,238.72	$5,011.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $371.54 / $1,380.38	Professional		$288.40	$371.54	$1,380.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $436.52 / $1,122.02 / $2,344.23	Professional	50	$436.52	$1,122.02	$2,344.23
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $288.40 / $288.40 / $630.96	Professional	54	$288.40	$288.40	$630.96
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $56.23 / $56.23 / $56.23	Professional	55	$56.23	$56.23	$56.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $295.12 / $371.54	Professional		$223.87	$295.12	$371.54
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $295.12 / $407.38 / $501.19	Professional	50	$295.12	$407.38	$501.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $3,467.37 / $4,466.84	Facility		$1,513.56	$3,467.37	$4,466.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $295.12 / $588.84	Professional		$72.44	$295.12	$588.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $363.08 / $602.56	Professional		$229.09	$363.08	$602.56
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $398.11 / $588.84	Professional		$295.12	$398.11	$588.84
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $467.74 / $501.19	Professional		$407.38	$467.74	$501.19
Select Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $331.13 / $331.13	Professional		$275.42	$331.13	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $1,584.89 / $4,786.30	Facility		$407.38	$1,584.89	$4,786.30
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $323.59 / $549.54	Professional		$263.03	$323.59	$549.54