Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $269.15	Professional		$190.55	$190.55	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $190.55	Professional		$162.18	$162.18	$190.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $199.53 / $616.60	Facility		$190.55	$199.53	$616.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $204.17	Professional		$190.55	$190.55	$204.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $316.23	Professional		$169.82	$169.82	$316.23
Select Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $204.17 / $204.17	Professional		$169.82	$204.17	$204.17