Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $436.52 / $912.01	Facility		$48.98	$436.52	$912.01
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 $48.98 / $165.96 / $537.03	Facility	TC	$48.98	$165.96	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $38.02 / $134.90	Professional		$14.79	$38.02	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.22 / $42.66	Professional	26	$7.08	$11.22	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $63.10 / $63.10 / $165.96	Professional	50	$63.10	$63.10	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $29.51 / $97.72	Professional	TC	$19.95	$29.51	$97.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $24.55 / $31.62	Professional		$19.50	$24.55	$31.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $6.76 / $13.18	Professional	26	$6.17	$6.76	$13.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $32.36 / $36.31 / $40.74	Professional	50	$32.36	$36.31	$40.74
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $19.05 / $36.31	Professional	TC	$16.22	$19.05	$36.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $43.65 / $43.65	Facility		$27.54	$43.65	$43.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $53.70	Professional		$30.90	$30.90	$53.70
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 50 Low / Median / High Price $36.31 / $44.67 / $60.26	Professional	50	$36.31	$44.67	$60.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $22.91 / $39.81	Professional	TC	$22.91	$22.91	$39.81
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 $27.54 / $38.02 / $61.66	Professional		$27.54	$38.02	$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 $19.95 / $28.18 / $45.71	Professional	TC	$19.95	$28.18	$45.71
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.24 / $39.81 / $52.48	Professional		$0.24	$39.81	$52.48
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $10.00 / $13.18	Professional	26	$0.09	$10.00	$13.18
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.15 / $29.51 / $39.81	Professional	TC	$0.15	$29.51	$39.81
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.24 / $0.24 / $48.98	Professional		$0.24	$0.24	$48.98
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $0.09 / $12.59	Professional	26	$0.09	$0.09	$12.59
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.15 / $0.15 / $37.15	Professional	TC	$0.15	$0.15	$37.15
Select Health Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $33.11 / $33.11	Professional		$31.62	$33.11	$33.11
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 / $24.55 / $24.55	Professional	TC	$23.44	$24.55	$24.55
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $33.11 / $53.70	Professional		$25.12	$33.11	$53.70
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 $19.05 / $22.39 / $38.90	Professional	TC	$19.05	$22.39	$38.90