Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.47 / $186.39 / $411.29	Facility		$164.47	$186.39	$411.29
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $419.82 / $419.82 / $419.82	Facility	25	$419.82	$419.82	$419.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.56 / $219.28 / $631.00	Professional		$139.56	$219.28	$631.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $144.47 / $261.95 / $699.00	Professional	25	$144.47	$261.95	$699.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $181.93 / $214.04 / $378.99	Professional		$181.93	$214.04	$378.99
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $190.67 / $214.04 / $365.25	Professional	25	$190.67	$214.04	$365.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.55 / $211.35 / $357.99	Professional		$136.55	$211.35	$357.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $105.00 / $130.00 / $287.20	Facility		$105.00	$130.00	$287.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.04 / $218.65 / $348.56	Professional		$144.04	$218.65	$348.56
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $200.41 / $352.37	Professional		$65.00	$200.41	$352.37
Hometown Health Facility/Professional Professional Modifier 25 Low / Median / High Price $844.76 / $844.76 / $844.76	Professional	25	$844.76	$844.76	$844.76
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.30 / $158.35 / $352.37	Professional		$1.30	$158.35	$352.37
United Facility/Professional Facility Modifier Low / Median / High Price $155.00 / $155.00 / $155.00	Facility		$155.00	$155.00	$155.00
United Facility/Professional Professional Modifier Low / Median / High Price $171.10 / $220.36 / $380.24	Professional		$171.10	$220.36	$380.24
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $88.00 / $88.00	Professional	25	$80.00	$88.00	$88.00