Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.97 / $643.08 / $728.28	Facility		$119.97	$643.08	$728.28
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.30 / $10.90 / $97.85	Facility	26	$10.30	$10.90	$97.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.34 / $202.37 / $500.12	Facility	TC	$32.34	$202.37	$500.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $45.38 / $168.48	Professional		$36.65	$45.38	$168.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $15.35 / $48.45	Professional	26	$10.68	$15.35	$48.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.28 / $38.59 / $127.00	Professional	TC	$29.28	$38.59	$127.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.56 / $48.76 / $68.14	Professional		$29.56	$48.76	$68.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.24 / $15.24 / $22.44	Professional	26	$8.24	$15.24	$22.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.25 / $34.25 / $34.25	Professional	TC	$34.25	$34.25	$34.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $40.07 / $50.09 / $50.09	Facility		$40.07	$50.09	$50.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $39.60 / $49.83	Professional		$34.79	$39.60	$49.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $12.01 / $14.60	Professional	26	$8.83	$12.01	$14.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.57 / $28.84 / $35.86	Professional	TC	$24.57	$28.84	$35.86
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 $31.23 / $46.47 / $74.86	Professional		$31.23	$46.47	$74.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $14.03 / $20.60	Professional	26	$9.59	$14.03	$20.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.21 / $32.44 / $54.96	Professional	TC	$22.21	$32.44	$54.96
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.30 / $48.00 / $66.80	Professional		$0.30	$48.00	$66.80
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.12 / $13.18 / $17.20	Professional	26	$0.12	$13.18	$17.20
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.18 / $34.15 / $47.52	Professional	TC	$0.18	$34.15	$47.52
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 / $38.39 / $60.00	Professional		$0.30	$38.39	$60.00
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.12 / $10.30 / $15.45	Professional	26	$0.12	$10.30	$15.45
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.18 / $29.70 / $44.55	Professional	TC	$0.18	$29.70	$44.55
United Facility/Professional Professional Modifier Low / Median / High Price $29.96 / $38.61 / $70.29	Professional		$29.96	$38.61	$70.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $11.55 / $20.53	Professional	26	$8.52	$11.55	$20.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.20 / $27.07 / $49.27	Professional	TC	$21.20	$27.07	$49.27