Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.74 / $521.64 / $1,099.58	Facility		$158.74	$521.64	$1,099.58
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 $23.83 / $78.64 / $218.08	Facility	TC	$23.83	$78.64	$218.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.07 / $34.27 / $154.00	Professional		$13.07	$34.27	$154.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.48 / $11.72 / $47.79	Professional	26	$7.48	$11.72	$47.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $25.67 / $115.00	Professional	TC	$18.48	$25.67	$115.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.19 / $27.80 / $53.52	Professional		$19.19	$27.80	$53.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.91 / $10.94 / $16.10	Professional	26	$5.91	$10.94	$16.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.58 / $25.58 / $25.58	Professional	TC	$25.58	$25.58	$25.58
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 / $28.55 / $35.59	Professional		$25.62	$28.55	$35.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.44 / $8.31 / $10.50	Professional	26	$6.44	$8.31	$10.50
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $33.82 / $39.72 / $53.38	Professional	50	$33.82	$39.72	$53.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.75 / $20.32 / $26.50	Professional	TC	$18.75	$20.32	$26.50
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 $23.75 / $33.67 / $54.68	Professional		$23.75	$33.67	$54.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $10.03 / $14.60	Professional	26	$6.42	$10.03	$14.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.09 / $23.74 / $40.90	Professional	TC	$17.09	$23.74	$40.90
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.23 / $36.21 / $48.38	Professional		$0.23	$36.21	$48.38
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $9.53 / $12.57	Professional	26	$0.09	$9.53	$12.57
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $26.42 / $34.14	Professional	TC	$0.14	$26.42	$34.14
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 / $43.46	Professional		$0.23	$28.36	$43.46
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $7.63 / $11.45	Professional	26	$0.09	$7.63	$11.45
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $21.34 / $32.01	Professional	TC	$0.14	$21.34	$32.01
United Facility/Professional Professional Modifier Low / Median / High Price $21.97 / $29.23 / $55.08	Professional		$21.97	$29.23	$55.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.13 / $8.66 / $15.21	Professional	26	$6.13	$8.66	$15.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.12 / $20.57 / $37.44	Professional	TC	$16.12	$20.57	$37.44