Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.11 / $517.20 / $810.83	Facility		$75.11	$517.20	$810.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.71 / $8.19 / $9.84	Facility	26	$7.71	$8.19	$9.84
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.97 / $55.32 / $231.24	Facility	TC	$25.97	$55.32	$231.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.72 / $39.00 / $183.88	Professional		$18.72	$39.00	$183.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $14.16 / $41.00	Professional	26	$8.15	$14.16	$41.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.75 / $17.39 / $183.88	Professional	52	$15.75	$17.39	$183.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.07 / $26.43 / $114.00	Professional	TC	$20.07	$26.43	$114.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.09 / $26.06 / $61.32	Professional		$25.09	$26.06	$61.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.22 / $11.03 / $15.14	Professional	26	$6.22	$11.03	$15.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.02 / $42.53 / $42.53	Facility		$34.02	$42.53	$42.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.24 / $31.40 / $41.19	Professional		$29.24	$31.40	$41.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $8.92 / $10.90	Professional	26	$6.74	$8.92	$10.90
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.27 / $46.09 / $61.79	Professional	50	$39.27	$46.09	$61.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.85 / $23.01 / $31.79	Professional	TC	$21.85	$23.01	$31.79
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 $25.35 / $37.22 / $63.40	Professional		$25.35	$37.22	$63.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.30 / $10.50 / $15.22	Professional	26	$7.30	$10.50	$15.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.57 / $28.50 / $48.47	Professional	TC	$18.57	$28.50	$48.47
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.23 / $42.24 / $57.31	Professional		$0.23	$42.24	$57.31
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $10.54 / $13.86	Professional	26	$0.09	$10.54	$13.86
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $31.22 / $41.63	Professional	TC	$0.14	$31.22	$41.63
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 / $32.57 / $51.48	Professional		$0.23	$32.57	$51.48
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $8.30 / $12.45	Professional	26	$0.09	$8.30	$12.45
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $26.02 / $39.03	Professional	TC	$0.14	$26.02	$39.03
United Facility/Professional Professional Modifier Low / Median / High Price $22.19 / $33.20 / $56.23	Professional		$22.19	$33.20	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.99 / $8.66 / $15.21	Professional	26	$5.99	$8.66	$15.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.34 / $24.54 / $41.02	Professional	TC	$15.34	$24.54	$41.02