Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $245.47 / $691.83	Facility		$58.88	$245.47	$691.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $10.47 / $66.07	Facility	26	$10.00	$10.47	$66.07
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $48.98 / $194.98 / $575.44	Facility	TC	$48.98	$194.98	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $39.81 / $138.04	Professional		$27.54	$39.81	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.80 / $52.48	Professional	26	$8.91	$13.80	$52.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $25.70 / $93.33	Professional	TC	$17.78	$25.70	$93.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $25.12 / $37.15	Professional		$21.38	$25.12	$37.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $8.32 / $14.79	Professional	26	$7.76	$8.32	$14.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $18.62 / $33.88	Professional	TC	$14.45	$18.62	$33.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $43.65 / $43.65	Facility		$26.92	$43.65	$43.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $31.62 / $53.70	Professional		$31.62	$31.62	$53.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $9.77 / $16.98	Professional	26	$9.77	$9.77	$16.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $21.88 / $36.31	Professional	TC	$21.88	$21.88	$36.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $169.82 / $416.87	Facility		$23.44	$169.82	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $36.31 / $63.10	Professional		$24.55	$36.31	$63.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.30 / $19.50	Professional	26	$8.71	$12.30	$19.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $23.99 / $43.65	Professional	TC	$16.60	$23.99	$43.65
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.28 / $39.81 / $52.48	Professional		$0.28	$39.81	$52.48
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.12 / $12.02 / $15.85	Professional	26	$0.12	$12.02	$15.85
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $30.20 / $38.90	Professional	TC	$15.14	$30.20	$38.90
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.28 / $0.28 / $48.98	Professional		$0.28	$0.28	$48.98
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.12 / $0.12 / $14.79	Professional	26	$0.12	$0.12	$14.79
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $34.67 / $35.48	Professional	TC	$34.67	$34.67	$35.48
Select Health Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $10.00 / $10.00	Professional	26	$10.00	$10.00	$10.00
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $22.91 / $22.91	Professional	TC	$22.39	$22.91	$22.91
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $33.11 / $54.95	Professional		$24.55	$33.11	$54.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $11.22 / $18.20	Professional	26	$8.71	$11.22	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $21.88 / $36.31	Professional	TC	$15.49	$21.88	$36.31