Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $407.38 / $512.86	Facility		$204.17	$407.38	$512.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $575.44	Professional		$204.17	$204.17	$575.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $213.80 / $645.65	Facility		$204.17	$213.80	$645.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $204.17 / $204.17	Facility		$199.53	$204.17	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $204.17 / $263.03	Professional		$199.53	$204.17	$263.03
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $229.09	Professional		$199.53	$199.53	$229.09
Select Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Professional		$204.17	$204.17	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $0.21 / $0.21 / $0.21	Facility		$0.21	$0.21	$0.21
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $204.17 / $229.09	Professional		$154.88	$204.17	$229.09