Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.56 / $553.78 / $808.02	Facility		$101.56	$553.78	$808.02
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.03 / $8.53 / $10.25	Facility	26	$8.03	$8.53	$10.25
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $36.04 / $158.74 / $533.04	Facility	TC	$36.04	$158.74	$533.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.22 / $51.19 / $224.31	Professional		$22.22	$51.19	$224.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.48 / $19.07 / $49.78	Professional	26	$8.48	$19.07	$49.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.85 / $17.85 / $299.48	Professional	50	$17.85	$17.85	$299.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.75 / $52.71 / $174.53	Professional	TC	$28.75	$52.71	$174.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.70 / $34.01 / $70.73	Professional		$30.70	$34.01	$70.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.43 / $11.90 / $17.52	Professional	26	$6.43	$11.90	$17.52
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $46.05 / $46.05 / $46.05	Professional	50	$46.05	$46.05	$46.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.84 / $52.30 / $52.30	Facility		$41.84	$52.30	$52.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $37.39 / $50.13	Professional		$35.09	$37.39	$50.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.98 / $9.09 / $11.40	Professional	26	$6.98	$9.09	$11.40
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $47.01 / $53.88 / $75.19	Professional	50	$47.01	$53.88	$75.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.99 / $30.09 / $40.34	Professional	TC	$26.99	$30.09	$40.34
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 $29.70 / $44.98 / $76.48	Professional		$29.70	$44.98	$76.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.98 / $10.75 / $16.00	Professional	26	$6.98	$10.75	$16.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.20 / $34.03 / $60.64	Professional	TC	$23.20	$34.03	$60.64
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.24 / $51.22 / $71.28	Professional		$0.24	$51.22	$71.28
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.10 / $10.46 / $13.81	Professional	26	$0.10	$10.46	$13.81
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $40.58 / $54.48	Professional	TC	$0.14	$40.58	$54.48
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 $0.24 / $40.01 / $64.02	Professional		$0.24	$40.01	$64.02
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.10 / $8.63 / $12.95	Professional	26	$0.10	$8.63	$12.95
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $34.04 / $51.08	Professional	TC	$0.14	$34.04	$51.08
United Facility/Professional Facility Modifier Low / Median / High Price $182.03 / $182.03 / $182.03	Facility		$182.03	$182.03	$182.03
United Facility/Professional Professional Modifier Low / Median / High Price $25.57 / $39.34 / $65.34	Professional		$25.57	$39.34	$65.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.26 / $9.02 / $16.42	Professional	26	$6.26	$9.02	$16.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.86 / $30.32 / $50.03	Professional	TC	$18.86	$30.32	$50.03