Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $295.12 / $478.63	Facility		$165.96	$295.12	$478.63
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $263.03 / $263.03 / $724.44	Facility	25	$263.03	$263.03	$724.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $128.82 / $338.84	Professional		$67.61	$128.82	$338.84
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $66.07 / $138.04 / $371.54	Professional	25	$66.07	$138.04	$371.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	50	$95.50	$95.50	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $117.49 / $165.96	Professional		$81.28	$117.49	$165.96
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $89.13 / $123.03 / $169.82	Professional	25	$89.13	$123.03	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $114.82 / $208.93	Professional		$72.44	$114.82	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $165.96 / $194.98	Facility		$104.71	$165.96	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $112.20 / $199.53	Professional		$75.86	$112.20	$199.53
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.68 / $109.65 / $181.97	Professional		$0.68	$109.65	$181.97
Hometown Health Facility/Professional Professional Modifier 25 Low / Median / High Price $346.74 / $346.74 / $346.74	Professional	25	$346.74	$346.74	$346.74
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.68 / $125.89 / $204.17	Professional		$0.68	$125.89	$204.17
Select Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $123.03 / $154.88	Professional		$64.57	$123.03	$154.88
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $104.71 / $190.55	Professional		$66.07	$104.71	$190.55