Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,127.00 / $3,929.00 / $7,802.00	Facility		$2,127.00	$3,929.00	$7,802.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $138.66 / $138.66 / $165.01	Facility	53	$138.66	$138.66	$165.01
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $520.00 / $520.00 / $618.79	Facility	54	$520.00	$520.00	$618.79
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $104.00 / $104.00 / $123.76	Facility	55	$104.00	$104.00	$123.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $584.94 / $736.28 / $1,113.95	Professional		$584.94	$736.28	$1,113.95
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $91.45 / $112.68 / $129.24	Professional	55	$91.45	$112.68	$129.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $612.84 / $612.84 / $653.04	Professional		$612.84	$612.84	$653.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,877.00 / $5,379.00 / $8,190.00	Facility		$3,877.00	$5,379.00	$8,190.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $599.04 / $795.54 / $965.46	Professional		$599.04	$795.54	$965.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,955.77 / $3,955.77 / $3,955.77	Facility		$3,955.77	$3,955.77	$3,955.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $557.63 / $738.58 / $1,247.99	Professional		$557.63	$738.58	$1,247.99
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $549.66 / $966.25 / $5,240.18	Professional		$549.66	$966.25	$5,240.18
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $5,702.41 / $5,702.41 / $5,702.41	Facility		$5,702.41	$5,702.41	$5,702.41
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $578.59 / $653.04 / $6,288.21	Professional		$578.59	$653.04	$6,288.21
United Facility/Professional Facility Modifier Low / Median / High Price $2,042.00 / $4,794.00 / $11,445.00	Facility		$2,042.00	$4,794.00	$11,445.00
United Facility/Professional Professional Modifier Low / Median / High Price $632.00 / $759.78 / $1,224.50	Professional		$632.00	$759.78	$1,224.50