Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $407.38 / $407.38	Facility		$186.21	$407.38	$407.38
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $416.87 / $416.87 / $416.87	Facility	25	$416.87	$416.87	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $239.88 / $724.44	Professional		$144.54	$239.88	$724.44
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $165.96 / $288.40 / $776.25	Professional	25	$165.96	$288.40	$776.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $213.80 / $316.23	Professional		$158.49	$213.80	$316.23
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $173.78 / $208.93 / $281.84	Professional	25	$173.78	$208.93	$281.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $213.80 / $380.19	Professional		$141.25	$213.80	$380.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $186.21 / $288.40	Facility		$104.71	$186.21	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $218.78 / $363.08	Professional		$154.88	$218.78	$363.08
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.29 / $204.17 / $316.23	Professional		$1.29	$204.17	$316.23
Hometown Health Facility/Professional Professional Modifier 25 Low / Median / High Price $851.14 / $851.14 / $851.14	Professional	25	$851.14	$851.14	$851.14
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.29 / $239.88 / $354.81	Professional		$1.29	$239.88	$354.81
Select Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $234.42 / $309.03	Professional		$158.49	$234.42	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $204.17 / $363.08	Professional		$138.04	$204.17	$363.08