Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.23 / $369.85 / $520.76	Facility		$44.23	$369.85	$520.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.71 / $9.05 / $134.60	Facility	26	$7.71	$9.05	$134.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.28 / $84.74 / $429.54	Facility	TC	$23.28	$84.74	$429.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.92 / $46.55 / $261.88	Professional		$24.92	$46.55	$261.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.48 / $17.27 / $64.02	Professional	26	$7.48	$17.27	$64.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $73.37 / $73.37 / $73.37	Professional	50	$73.37	$73.37	$73.37
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.74 / $35.00 / $339.42	Professional	52	$15.74	$35.00	$339.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.69 / $25.68 / $126.46	Professional	TC	$18.69	$25.68	$126.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.39 / $24.24 / $46.06	Professional		$23.39	$24.24	$46.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.22 / $11.41 / $11.95	Professional	26	$6.22	$11.41	$11.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.64 / $39.54 / $39.54	Facility		$31.64	$39.54	$39.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.39 / $28.71 / $38.35	Professional		$27.39	$28.71	$38.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $8.31 / $10.90	Professional	26	$6.74	$8.31	$10.90
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $36.15 / $42.90 / $57.52	Professional	50	$36.15	$42.90	$57.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.84 / $20.78 / $28.95	Professional	TC	$19.84	$20.78	$28.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.44 / $203.39 / $670.85	Facility		$120.44	$203.39	$670.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.03 / $35.70 / $58.42	Professional		$24.03	$35.70	$58.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $10.03 / $15.22	Professional	26	$6.71	$10.03	$15.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.32 / $25.94 / $44.05	Professional	TC	$17.32	$25.94	$44.05
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.20 / $37.54 / $52.29	Professional		$0.20	$37.54	$52.29
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.07 / $9.94 / $12.74	Professional	26	$0.07	$9.94	$12.74
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.13 / $27.08 / $37.36	Professional	TC	$0.13	$27.08	$37.36
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $117.52 / $117.52 / $117.52	Facility		$117.52	$117.52	$117.52
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.20 / $30.30 / $46.97	Professional		$0.20	$30.30	$46.97
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.07 / $7.96 / $11.94	Professional	26	$0.07	$7.96	$11.94
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.13 / $23.35 / $35.03	Professional	TC	$0.13	$23.35	$35.03
United Facility/Professional Facility Modifier Low / Median / High Price $245.18 / $245.18 / $245.18	Facility		$245.18	$245.18	$245.18
United Facility/Professional Professional Modifier Low / Median / High Price $21.81 / $30.68 / $53.56	Professional		$21.81	$30.68	$53.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.08 / $8.66 / $15.12	Professional	26	$6.08	$8.66	$15.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.77 / $22.02 / $39.00	Professional	TC	$14.77	$22.02	$39.00