Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $346.74 / $724.44	Facility		$181.97	$346.74	$724.44
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $102.33 / $102.33 / $181.97	Facility	25	$102.33	$102.33	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $53.70 / $144.54	Professional		$28.84	$53.70	$144.54
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $34.67 / $61.66 / $158.49	Professional	25	$34.67	$61.66	$158.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $52.48 / $72.44	Professional		$30.90	$52.48	$72.44
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $41.69 / $53.70 / $69.18	Professional	25	$41.69	$53.70	$69.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $43.65 / $43.65 / $43.65	Professional	50	$43.65	$43.65	$43.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $47.86 / $93.33	Professional		$25.12	$47.86	$93.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $134.90 / $194.98	Facility		$74.13	$134.90	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $45.71 / $87.10	Professional		$26.30	$45.71	$87.10
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.30 / $44.67 / $79.43	Professional		$0.30	$44.67	$79.43
Hometown Health Facility/Professional Professional Modifier 25 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	25	$144.54	$144.54	$144.54
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.30 / $45.71 / $89.13	Professional		$0.30	$45.71	$89.13
Select Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $54.95 / $69.18	Professional		$30.90	$54.95	$69.18
United Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $42.66 / $79.43	Professional		$22.91	$42.66	$79.43