Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,862.00 / $3,939.00 / $7,674.00	Facility		$1,862.00	$3,939.00	$7,674.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $567.92 / $567.92 / $675.83	Facility	54	$567.92	$567.92	$675.83
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $113.59 / $113.59 / $135.16	Facility	55	$113.59	$113.59	$135.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $757.24 / $912.60 / $3,484.15	Professional		$757.24	$912.60	$3,484.15
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $567.92 / $684.45 / $1,068.38	Professional	54	$567.92	$684.45	$1,068.38
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $113.59 / $135.16 / $141.31	Professional	55	$113.59	$135.16	$141.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $466.96 / $667.08 / $1,380.86	Professional		$466.96	$667.08	$1,380.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,072.00 / $3,931.00 / $5,258.00	Facility		$3,072.00	$3,931.00	$5,258.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $717.79 / $923.63 / $1,249.60	Professional		$717.79	$923.63	$1,249.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,277.64 / $1,277.64 / $1,277.64	Facility		$1,277.64	$1,277.64	$1,277.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $659.95 / $908.68 / $1,363.03	Professional		$659.95	$908.68	$1,363.03
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $42.24 / $951.31 / $1,639.04	Professional		$42.24	$951.31	$1,639.04
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $2,520.62 / $2,520.62 / $2,520.62	Facility		$2,520.62	$2,520.62	$2,520.62
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $21.12 / $710.55 / $1,966.85	Professional		$21.12	$710.55	$1,966.85
United Facility/Professional Facility Modifier Low / Median / High Price $1,282.00 / $2,947.00 / $7,138.00	Facility		$1,282.00	$2,947.00	$7,138.00
United Facility/Professional Professional Modifier Low / Median / High Price $497.32 / $968.35 / $4,902.00	Professional		$497.32	$968.35	$4,902.00