Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,150.00 / $3,939.00 / $7,674.00	Facility		$2,150.00	$3,939.00	$7,674.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $110.56 / $110.56 / $131.56	Facility	53	$110.56	$110.56	$131.56
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $414.59 / $414.59 / $493.35	Facility	54	$414.59	$414.59	$493.35
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $82.92 / $82.92 / $98.67	Facility	55	$82.92	$82.92	$98.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $552.78 / $658.61 / $2,670.12	Professional		$552.78	$658.61	$2,670.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $4,329.68 / $4,329.68 / $4,329.68	Professional	50	$4,329.68	$4,329.68	$4,329.68
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $276.39 / $328.90 / $379.25	Professional	52	$276.39	$328.90	$379.25
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $414.59 / $493.96 / $646.97	Professional	54	$414.59	$493.96	$646.97
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $82.92 / $98.67 / $113.78	Professional	55	$82.92	$98.67	$113.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $341.09 / $518.97 / $1,280.06	Professional		$341.09	$518.97	$1,280.06
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 $524.03 / $674.30 / $912.29	Professional		$524.03	$674.30	$912.29
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $768.17 / $903.73 / $1,004.14	Professional	50	$768.17	$903.73	$1,004.14
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 $531.72 / $694.73 / $1,455.35	Professional		$531.72	$694.73	$1,455.35
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $33.60 / $727.01 / $1,639.04	Professional		$33.60	$727.01	$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 $16.80 / $518.97 / $1,966.85	Professional		$16.80	$518.97	$1,966.85
United Facility/Professional Facility Modifier Low / Median / High Price $1,263.74 / $3,000.00 / $5,027.00	Facility		$1,263.74	$3,000.00	$5,027.00
United Facility/Professional Professional Modifier Low / Median / High Price $540.75 / $684.39 / $1,023.92	Professional		$540.75	$684.39	$1,023.92