Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.02 / $2,079.00 / $4,396.00	Facility		$363.02	$2,079.00	$4,396.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $87.68 / $96.38 / $181.52	Facility	52	$87.68	$96.38	$181.52
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $37.78 / $87.84 / $181.75	Facility	53	$37.78	$87.84	$181.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.09 / $278.35 / $572.66	Professional		$180.09	$278.35	$572.66
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $38.14 / $87.81 / $192.33	Professional	53	$38.14	$87.81	$192.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $175.36 / $240.07 / $263.04	Professional		$175.36	$240.07	$263.04
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $99.65 / $122.98 / $122.98	Professional	53	$99.65	$122.98	$122.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,529.00 / $3,433.00 / $4,098.00	Facility		$1,529.00	$3,433.00	$4,098.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.06 / $338.41 / $538.14	Professional		$205.06	$338.41	$538.14
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $120.43 / $193.12 / $364.43	Professional	53	$120.43	$193.12	$364.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $515.00 / $672.33 / $718.96	Facility		$515.00	$672.33	$718.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.75 / $301.75 / $390.77	Professional		$301.75	$301.75	$390.77
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $106.08 / $131.02 / $149.00	Professional	53	$106.08	$131.02	$149.00
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $154.57 / $376.35 / $613.01	Professional		$154.57	$376.35	$613.01
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $533.04 / $1,007.60 / $1,007.60	Facility		$533.04	$1,007.60	$1,007.60
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $162.69 / $244.05 / $564.53	Professional		$162.69	$244.05	$564.53
United Facility/Professional Facility Modifier Low / Median / High Price $408.00 / $1,514.00 / $4,661.00	Facility		$408.00	$1,514.00	$4,661.00
United Facility/Professional Professional Modifier Low / Median / High Price $320.62 / $410.47 / $612.94	Professional		$320.62	$410.47	$612.94