Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.82 / $117.09 / $474.46	Facility		$87.82	$117.09	$474.46
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $19.80 / $19.80 / $261.00	Facility	25	$19.80	$19.80	$261.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.25 / $122.78 / $310.98	Professional		$64.25	$122.78	$310.98
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $56.69 / $135.75 / $364.00	Professional	25	$56.69	$135.75	$364.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.50 / $94.50 / $287.60	Professional	50	$94.50	$94.50	$287.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.05 / $124.42 / $202.76	Professional		$93.05	$124.42	$202.76
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $105.76 / $124.42 / $202.76	Professional	25	$105.76	$124.42	$202.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.00 / $108.71 / $201.34	Professional		$71.00	$108.71	$201.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $105.00 / $130.00 / $190.00	Facility		$105.00	$130.00	$190.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.76 / $114.56 / $196.11	Professional		$70.76	$114.56	$196.11
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $43.24 / $113.92 / $202.34	Professional		$43.24	$113.92	$202.34
Hometown Health Facility/Professional Professional Modifier 25 Low / Median / High Price $350.16 / $350.16 / $350.16	Professional	25	$350.16	$350.16	$350.16
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.68 / $125.61 / $202.34	Professional		$0.68	$125.61	$202.34
United Facility/Professional Professional Modifier Low / Median / High Price $87.32 / $116.28 / $208.07	Professional		$87.32	$116.28	$208.07