Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $416.87 / $676.08	Facility		$57.54	$416.87	$676.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $7.94 / $10.23	Facility	26	$7.94	$7.94	$10.23
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.84 / $165.96 / $398.11	Facility	TC	$28.84	$165.96	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $37.15 / $123.03	Professional		$25.70	$37.15	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.72 / $40.74	Professional	26	$7.08	$10.72	$40.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.70 / $52.48	Professional	TC	$19.05	$25.70	$52.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $24.55 / $32.36	Professional		$20.42	$24.55	$32.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $6.61 / $13.49	Professional	26	$6.17	$6.61	$13.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $18.20 / $19.50	Professional	TC	$15.14	$18.20	$19.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $41.69 / $41.69	Facility		$26.30	$41.69	$41.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.90 / $52.48	Professional		$30.20	$30.90	$52.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $7.94 / $13.80	Professional	26	$7.76	$7.94	$13.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $22.91 / $37.15	Professional	TC	$20.89	$22.91	$37.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $169.82 / $416.87	Facility		$24.55	$169.82	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $35.48 / $61.66	Professional		$25.12	$35.48	$61.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.47 / $15.85	Professional	26	$6.92	$10.47	$15.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $26.30 / $46.77	Professional	TC	$17.78	$26.30	$46.77
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.27 / $38.02 / $51.29	Professional		$0.27	$38.02	$51.29
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.12 / $10.00 / $13.18	Professional	26	$0.12	$10.00	$13.18
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.15 / $28.18 / $38.02	Professional	TC	$0.15	$28.18	$38.02
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.27 / $0.27 / $47.86	Professional		$0.27	$0.27	$47.86
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.12 / $0.12 / $12.59	Professional	26	$0.12	$0.12	$12.59
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.15 / $0.15 / $35.48	Professional	TC	$0.15	$0.15	$35.48
Select Health Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $31.62 / $31.62	Professional		$31.62	$31.62	$31.62
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.32 / $8.32	Professional	26	$7.94	$8.32	$8.32
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $23.44 / $23.44	Professional	TC	$23.44	$23.44	$23.44
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $31.62 / $52.48	Professional		$22.91	$31.62	$52.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $9.12 / $14.79	Professional	26	$6.31	$9.12	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $22.91 / $37.15	Professional	TC	$16.60	$22.91	$37.15