Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.12 / $482.73 / $544.01	Facility		$95.12	$482.73	$544.01
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.39 / $7.87 / $9.44	Facility	26	$7.39	$7.87	$9.44
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.79 / $74.86 / $298.77	Facility	TC	$26.79	$74.86	$298.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.07 / $37.54 / $142.01	Professional		$19.07	$37.54	$142.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.19 / $11.38 / $47.79	Professional	26	$7.19	$11.38	$47.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.79 / $25.51 / $123.00	Professional	TC	$20.79	$25.51	$123.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $24.76 / $58.32	Professional		$20.89	$24.76	$58.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.98 / $11.23 / $13.54	Professional	26	$5.98	$11.23	$13.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.98 / $22.98 / $22.98	Professional	TC	$22.98	$22.98	$22.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.32 / $40.40 / $40.40	Facility		$32.32	$40.40	$40.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.98 / $30.16 / $38.76	Professional		$27.98	$30.16	$38.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.44 / $8.99 / $11.03	Professional	26	$6.44	$8.99	$11.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.03 / $22.20 / $29.75	Professional	TC	$21.03	$22.20	$29.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.48 / $168.41 / $498.40	Facility		$89.48	$168.41	$498.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.18 / $36.81 / $59.66	Professional		$25.18	$36.81	$59.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.98 / $10.66 / $14.60	Professional	26	$6.98	$10.66	$14.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $27.54 / $45.95	Professional	TC	$18.20	$27.54	$45.95
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.25 / $38.38 / $53.41	Professional		$0.25	$38.38	$53.41
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $9.94 / $13.08	Professional	26	$0.09	$9.94	$13.08
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $28.43 / $38.43	Professional	TC	$0.16	$28.43	$38.43
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $97.31 / $97.31 / $97.31	Facility		$97.31	$97.31	$97.31
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.25 / $30.95 / $47.97	Professional		$0.25	$30.95	$47.97
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $7.96 / $11.94	Professional	26	$0.09	$7.96	$11.94
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $24.02 / $36.03	Professional	TC	$0.16	$24.02	$36.03
United Facility/Professional Professional Modifier Low / Median / High Price $24.65 / $31.76 / $57.60	Professional		$24.65	$31.76	$57.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.34 / $8.66 / $15.76	Professional	26	$6.34	$8.66	$15.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.48 / $23.10 / $40.94	Professional	TC	$16.48	$23.10	$40.94