Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $489.78 / $1,096.48	Facility		$79.43	$489.78	$1,096.48
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $7.08 / $9.33	Facility	26	$7.08	$7.08	$9.33
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $147.91 / $338.84	Facility	TC	$25.70	$147.91	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $33.88 / $114.82	Professional		$14.79	$33.88	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.72 / $43.65	Professional	26	$6.03	$10.72	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $141.25 / $141.25 / $144.54	Professional	50	$141.25	$141.25	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.12 / $61.66	Professional	TC	$16.98	$25.12	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $21.88 / $29.51	Professional		$18.20	$21.88	$29.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $6.17 / $11.48	Professional	26	$5.75	$6.17	$11.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $17.38 / $30.90	Professional	TC	$13.80	$17.38	$30.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $38.02 / $38.02	Facility		$23.99	$38.02	$38.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $27.54 / $46.77	Professional		$26.92	$27.54	$46.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $7.24 / $12.59	Professional	26	$7.08	$7.24	$12.59
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $32.36 / $40.74 / $53.70	Professional	50	$32.36	$40.74	$53.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $20.42 / $33.11	Professional	TC	$20.42	$20.42	$33.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $169.82 / $416.87	Facility		$21.88	$169.82	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $32.36 / $54.95	Professional		$23.99	$32.36	$54.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.77 / $14.45	Professional	26	$6.46	$9.77	$14.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $23.44 / $41.69	Professional	TC	$16.98	$23.44	$41.69
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.23 / $34.67 / $46.77	Professional		$0.23	$34.67	$46.77
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $9.12 / $12.30	Professional	26	$0.09	$9.12	$12.30
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $25.70 / $33.88	Professional	TC	$0.14	$25.70	$33.88
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.23 / $0.23 / $43.65	Professional		$0.23	$0.23	$43.65
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $0.09 / $11.48	Professional	26	$0.09	$0.09	$11.48
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $0.14 / $32.36	Professional	TC	$0.14	$0.14	$32.36
Select Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $28.84 / $28.84	Professional		$28.18	$28.84	$28.84
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $7.59 / $7.59	Professional	26	$7.41	$7.59	$7.59
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $21.38 / $21.38	Professional	TC	$20.89	$21.38	$21.38
United Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $29.51 / $47.86	Professional		$20.89	$29.51	$47.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $8.71 / $13.49	Professional	26	$5.75	$8.71	$13.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $20.42 / $33.88	Professional	TC	$15.14	$20.42	$33.88