Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $173.78 / $218.78	Facility		$85.11	$173.78	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $87.10 / $13,182.57	Professional		$85.11	$87.10	$13,182.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $91.20 / $275.42	Facility		$87.10	$91.20	$275.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $89.13	Professional		$87.10	$87.10	$89.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Facility		$87.10	$87.10	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $95.50	Professional		$89.13	$89.13	$95.50
Select Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $89.13	Professional		$87.10	$87.10	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $102.33	Professional		$87.10	$87.10	$102.33