Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.59 / $633.67 / $700.61	Facility		$49.59	$633.67	$700.61
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $9.89 / $11.87	Facility	26	$9.33	$9.89	$11.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.68 / $69.73 / $218.08	Facility	TC	$25.68	$69.73	$218.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.17 / $38.68 / $159.11	Professional		$33.17	$38.68	$159.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.73 / $14.87 / $56.00	Professional	26	$9.73	$14.87	$56.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.01 / $25.68 / $58.57	Professional	TC	$21.01	$25.68	$58.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.66 / $25.54 / $39.90	Professional		$24.66	$25.54	$39.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $13.81 / $14.18	Professional	26	$7.50	$13.81	$14.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $33.28 / $41.60 / $41.60	Facility		$33.28	$41.60	$41.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.70 / $34.84 / $42.28	Professional		$28.70	$34.84	$42.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $11.42 / $14.32	Professional	26	$8.02	$11.42	$14.32
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.66 / $23.04 / $28.66	Professional	TC	$20.66	$23.04	$28.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.44 / $203.39 / $670.85	Facility		$120.44	$203.39	$670.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.07 / $41.92 / $62.25	Professional		$28.07	$41.92	$62.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.92 / $13.50 / $18.35	Professional	26	$8.92	$13.50	$18.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.54 / $28.69 / $45.18	Professional	TC	$19.54	$28.69	$45.18
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.30 / $41.86 / $55.08	Professional		$0.30	$41.86	$55.08
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.12 / $12.25 / $16.07	Professional	26	$0.12	$12.25	$16.07
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.18 / $29.19 / $37.89	Professional	TC	$0.18	$29.19	$37.89
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $117.52 / $117.52 / $117.52	Facility		$117.52	$117.52	$117.52
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.30 / $31.92 / $49.47	Professional		$0.30	$31.92	$49.47
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.12 / $9.63 / $14.45	Professional	26	$0.12	$9.63	$14.45
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.18 / $23.35 / $35.03	Professional	TC	$0.18	$23.35	$35.03
United Facility/Professional Professional Modifier Low / Median / High Price $28.60 / $36.38 / $58.46	Professional		$28.60	$36.38	$58.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $10.48 / $19.05	Professional	26	$7.78	$10.48	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $22.60 / $40.04	Professional	TC	$18.48	$22.60	$40.04