Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $547.12 / $2,173.00 / $4,730.00	Facility		$547.12	$2,173.00	$4,730.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $237.35 / $255.78 / $304.38	Facility	54	$237.35	$255.78	$304.38
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $47.47 / $51.16 / $60.88	Facility	55	$47.47	$51.16	$60.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.14 / $342.98 / $1,105.71	Professional		$269.14	$342.98	$1,105.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $436.08 / $816.74 / $2,346.00	Professional	50	$436.08	$816.74	$2,346.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $214.96 / $276.52 / $323.58	Professional	54	$214.96	$276.52	$323.58
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $42.99 / $55.31 / $64.72	Professional	55	$42.99	$55.31	$64.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $276.79 / $297.58 / $403.26	Professional		$276.79	$297.58	$403.26
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $584.42 / $584.42 / $864.12	Professional	50	$584.42	$584.42	$864.12
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 $274.77 / $310.14 / $402.75	Professional		$274.77	$310.14	$402.75
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $407.66 / $479.60 / $532.89	Professional	50	$407.66	$479.60	$532.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.88 / $309.88 / $309.88	Facility		$309.88	$309.88	$309.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.29 / $362.00 / $601.03	Professional		$239.29	$362.00	$601.03
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $246.58 / $367.59 / $527.99	Professional		$246.58	$367.59	$527.99
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 $273.98 / $318.64 / $472.86	Professional		$273.98	$318.64	$472.86
United Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $1,925.00 / $4,661.00	Facility		$408.00	$1,925.00	$4,661.00
United Facility/Professional Professional Modifier Low / Median / High Price $255.35 / $335.88 / $582.79	Professional		$255.35	$335.88	$582.79