Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.91 / $395.82 / $685.36	Facility		$47.91	$395.82	$685.36
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.71 / $9.05 / $9.84	Facility	26	$7.71	$9.05	$9.84
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.46 / $65.59 / $400.74	Facility	TC	$23.46	$65.59	$400.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.80 / $38.52 / $163.79	Professional		$16.80	$38.52	$163.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.17 / $15.59 / $47.00	Professional	26	$7.17	$15.59	$47.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $23.06 / $49.32	Professional	TC	$18.82	$23.06	$49.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.93 / $22.69 / $53.52	Professional		$21.93	$22.69	$53.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $11.41 / $11.95	Professional	26	$6.17	$11.41	$11.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.19 / $25.19 / $25.19	Professional	TC	$25.19	$25.19	$25.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $29.59 / $36.99 / $36.99	Facility		$29.59	$36.99	$36.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.62 / $28.57 / $35.49	Professional		$25.62	$28.57	$35.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $7.93 / $10.00	Professional	26	$6.74	$7.93	$10.00
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $33.82 / $39.72 / $53.24	Professional	50	$33.82	$39.72	$53.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.35 / $20.64 / $26.09	Professional	TC	$18.35	$20.64	$26.09
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 $23.79 / $34.56 / $54.68	Professional		$23.79	$34.56	$54.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.44 / $9.60 / $15.22	Professional	26	$6.44	$9.60	$15.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.09 / $24.74 / $40.27	Professional	TC	$17.09	$24.74	$40.27
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.23 / $36.63 / $48.93	Professional		$0.23	$36.63	$48.93
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.07 / $9.65 / $12.74	Professional	26	$0.07	$9.65	$12.74
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $26.68 / $34.65	Professional	TC	$0.16	$26.68	$34.65
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 $0.23 / $28.36 / $43.95	Professional		$0.23	$28.36	$43.95
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.07 / $7.96 / $11.94	Professional	26	$0.07	$7.96	$11.94
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $21.34 / $32.01	Professional	TC	$0.16	$21.34	$32.01
United Facility/Professional Facility Modifier Low / Median / High Price $30.38 / $30.38 / $30.38	Facility		$30.38	$30.38	$30.38
United Facility/Professional Professional Modifier Low / Median / High Price $22.15 / $28.87 / $52.54	Professional		$22.15	$28.87	$52.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.16 / $8.66 / $14.45	Professional	26	$6.16	$8.66	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.62 / $20.21 / $36.78	Professional	TC	$15.62	$20.21	$36.78