Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Facility		$302.00	$302.00	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $1,122.02	Professional		$302.00	$302.00	$1,122.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $95.50 / $147.91	Professional		$57.54	$95.50	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Professional		$50.12	$50.12	$50.12
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.74 / $1.74 / $2.82	Professional		$1.74	$1.74	$2.82
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.74 / $1.74 / $1.74	Professional		$1.74	$1.74	$1.74
Select Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $85.11 / $89.13	Professional		$74.13	$85.11	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20