Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.90 / $521.64 / $748.99	Facility		$98.90	$521.64	$748.99
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 $39.35 / $167.22 / $540.60	Facility	TC	$39.35	$167.22	$540.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.20 / $41.36 / $158.00	Professional		$11.20	$41.36	$158.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $17.98 / $68.00	Professional	26	$8.13	$17.98	$68.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $57.92 / $64.50 / $114.57	Professional	50	$57.92	$64.50	$114.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.51 / $45.17 / $151.54	Professional	TC	$24.51	$45.17	$151.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.78 / $35.38 / $54.92	Professional		$27.78	$35.38	$54.92
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 $41.67 / $41.67 / $41.67	Professional	50	$41.67	$41.67	$41.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.75 / $47.19 / $47.19	Facility		$37.75	$47.19	$47.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.34 / $33.75 / $45.24	Professional		$31.34	$33.75	$45.24
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 $42.31 / $49.21 / $67.86	Professional	50	$42.31	$49.21	$67.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $26.45 / $35.46	Professional	TC	$23.44	$26.45	$35.46
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 $27.77 / $40.00 / $68.39	Professional		$27.77	$40.00	$68.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.98 / $10.75 / $15.84	Professional	26	$6.98	$10.75	$15.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.69 / $30.89 / $53.40	Professional	TC	$20.69	$30.89	$53.40
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.25 / $44.28 / $64.01	Professional		$0.25	$44.28	$64.01
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $10.46 / $13.81	Professional	26	$0.09	$10.46	$13.81
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $34.15 / $47.52	Professional	TC	$0.16	$34.15	$47.52
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 $0.25 / $36.13 / $57.50	Professional		$0.25	$36.13	$57.50
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $8.63 / $12.95	Professional	26	$0.09	$8.63	$12.95
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $29.70 / $44.55	Professional	TC	$0.16	$29.70	$44.55
United Facility/Professional Facility Modifier Low / Median / High Price $37.99 / $37.99 / $37.99	Facility		$37.99	$37.99	$37.99
United Facility/Professional Professional Modifier Low / Median / High Price $23.60 / $35.36 / $61.74	Professional		$23.60	$35.36	$61.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.25 / $9.02 / $15.84	Professional	26	$6.25	$9.02	$15.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.77 / $26.35 / $47.96	Professional	TC	$16.77	$26.35	$47.96