Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $535.72 / $929.23 / $945.61	Facility		$535.72	$929.23	$945.61
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $782.81 / $945.72 / $977.41	Facility	25	$782.81	$945.72	$977.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.50 / $63.06 / $85.60	Professional		$48.50	$63.06	$85.60
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $58.85 / $97.07 / $317.72	Professional	25	$58.85	$97.07	$317.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.05 / $168.61 / $253.22	Professional		$66.05	$168.61	$253.22
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $67.44 / $168.61 / $256.89	Professional	25	$67.44	$168.61	$256.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,167.00 / $1,167.00 / $1,437.00	Facility		$1,167.00	$1,167.00	$1,437.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.63 / $85.07 / $300.00	Professional		$55.63	$85.07	$300.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $837.00 / $1,021.00 / $1,097.00	Facility		$837.00	$1,021.00	$1,097.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.44 / $78.34 / $124.55	Professional		$51.44	$78.34	$124.55
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.83 / $75.20 / $132.00	Professional		$0.83	$75.20	$132.00
Hometown Health Facility/Professional Professional Modifier 25 Low / Median / High Price $369.25 / $369.25 / $369.25	Professional	25	$369.25	$369.25	$369.25
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.83 / $68.37 / $102.56	Professional		$0.83	$68.37	$102.56
United Facility/Professional Professional Modifier Low / Median / High Price $56.32 / $72.34 / $121.93	Professional		$56.32	$72.34	$121.93