Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $165.96 / $208.93	Facility		$81.28	$165.96	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $102.33	Professional		$81.28	$81.28	$102.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $87.10 / $263.03	Facility		$81.28	$87.10	$263.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $85.11	Professional		$81.28	$81.28	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Facility		$81.28	$81.28	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Professional		$81.28	$81.28	$81.28
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $87.10 / $97.72	Professional		$81.28	$87.10	$97.72
Select Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $85.11	Professional		$81.28	$81.28	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $95.50	Professional		$81.28	$81.28	$95.50