Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $389.05 / $851.14	Facility		$89.13	$389.05	$851.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $9.12 / $87.10	Facility	26	$8.91	$9.12	$87.10
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $51.29 / $186.21 / $794.33	Facility	TC	$51.29	$186.21	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $41.69 / $123.03	Professional		$15.85	$41.69	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.30 / $52.48	Professional	26	$7.94	$12.30	$52.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.05 / $77.62 / $151.36	Professional	50	$19.05	$77.62	$151.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $31.62 / $102.33	Professional	TC	$19.95	$31.62	$102.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $26.30 / $38.90	Professional		$21.38	$26.30	$38.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $7.24 / $13.49	Professional	26	$6.46	$7.24	$13.49
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $31.62 / $39.81 / $45.71	Professional	50	$31.62	$39.81	$45.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $20.89 / $39.81	Professional	TC	$17.38	$20.89	$39.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $46.77 / $46.77	Facility		$29.51	$46.77	$46.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $32.36 / $54.95	Professional		$30.90	$32.36	$54.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $8.51 / $14.79	Professional	26	$8.32	$8.51	$14.79
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.90 / $47.86 / $63.10	Professional	50	$38.90	$47.86	$63.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $23.99 / $39.81	Professional	TC	$20.89	$23.99	$39.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $169.82 / $416.87	Facility		$25.70	$169.82	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.02 / $64.57	Professional		$26.92	$38.02	$64.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.96 / $16.98	Professional	26	$7.94	$10.96	$16.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $26.30 / $50.12	Professional	TC	$18.62	$26.30	$50.12
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.24 / $42.66 / $57.54	Professional		$0.24	$42.66	$57.54
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.10 / $10.72 / $14.79	Professional	26	$0.10	$10.72	$14.79
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $32.36 / $42.66	Professional	TC	$0.14	$32.36	$42.66
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.24 / $0.24 / $53.70	Professional		$0.24	$0.24	$53.70
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.10 / $0.10 / $13.49	Professional	26	$0.10	$0.10	$13.49
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $0.14 / $39.81	Professional	TC	$0.14	$0.14	$39.81
Select Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $35.48 / $35.48	Professional		$33.88	$35.48	$35.48
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $8.91 / $8.91	Professional	26	$8.71	$8.91	$8.91
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $26.92 / $26.92	Professional	TC	$25.12	$26.92	$26.92
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $33.88 / $54.95	Professional		$22.91	$33.88	$54.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.77 / $15.85	Professional	26	$6.61	$9.77	$15.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $23.99 / $38.90	Professional	TC	$16.60	$23.99	$38.90