Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.79 / $1,639.00 / $4,473.00	Facility		$137.79	$1,639.00	$4,473.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $117.00 / $237.26	Professional		$90.00	$117.00	$237.26
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $158.16 / $182.48 / $272.51	Professional	50	$158.16	$182.48	$272.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $108.40 / $108.40 / $210.00	Professional		$108.40	$108.40	$210.00
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $162.60 / $162.60 / $315.00	Professional	50	$162.60	$162.60	$315.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,779.00 / $3,647.00 / $4,098.00	Facility		$2,779.00	$3,647.00	$4,098.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.01 / $119.87 / $154.38	Professional		$93.01	$119.87	$154.38
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $137.55 / $161.82 / $179.80	Professional	50	$137.55	$161.82	$179.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.60 / $61.60 / $61.60	Facility		$61.60	$61.60	$61.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.83 / $133.15 / $412.09	Professional		$86.83	$133.15	$412.09
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $60.25 / $113.68 / $196.67	Professional		$60.25	$113.68	$196.67
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $366.58 / $366.58 / $366.58	Facility		$366.58	$366.58	$366.58
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $74.90 / $100.41 / $112.35	Professional		$74.90	$100.41	$112.35
United Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $1,277.00 / $1,975.00	Facility		$200.00	$1,277.00	$1,975.00
United Facility/Professional Professional Modifier Low / Median / High Price $98.88 / $168.83 / $280.18	Professional		$98.88	$168.83	$280.18