Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.92 / $604.12 / $687.23	Facility		$108.92	$604.12	$687.23
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.30 / $10.90 / $13.08	Facility	26	$10.30	$10.90	$13.08
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $43.64 / $158.74 / $395.82	Facility	TC	$43.64	$158.74	$395.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.35 / $53.74 / $228.00	Professional		$15.35	$53.74	$228.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.03 / $14.53 / $52.02	Professional	26	$10.03	$14.53	$52.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.13 / $43.95 / $180.00	Professional	TC	$29.13	$43.95	$180.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.40 / $38.42 / $70.15	Professional		$35.40	$38.42	$70.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.24 / $11.70 / $22.44	Professional	26	$8.24	$11.70	$22.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $43.71 / $43.71 / $43.71	Professional	TC	$43.71	$43.71	$43.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $48.24 / $60.30 / $60.30	Facility		$48.24	$60.30	$60.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.21 / $49.50 / $68.95	Professional		$42.21	$49.50	$68.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $12.50 / $17.30	Professional	26	$9.44	$12.50	$17.30
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $57.87 / $65.77 / $86.61	Professional	50	$57.87	$65.77	$86.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.79 / $38.21 / $51.71	Professional	TC	$30.79	$38.21	$51.71
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 $33.17 / $52.25 / $87.71	Professional		$33.17	$52.25	$87.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.92 / $14.01 / $20.22	Professional	26	$8.92	$14.01	$20.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.25 / $40.35 / $67.48	Professional	TC	$24.25	$40.35	$67.48
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.27 / $55.99 / $81.31	Professional		$0.27	$55.99	$81.31
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $13.30 / $17.48	Professional	26	$0.09	$13.30	$17.48
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.18 / $43.77 / $60.90	Professional	TC	$0.18	$43.77	$60.90
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 $0.27 / $46.15 / $73.04	Professional		$0.27	$46.15	$73.04
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $10.64 / $15.96	Professional	26	$0.09	$10.64	$15.96
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.18 / $38.06 / $57.09	Professional	TC	$0.18	$38.06	$57.09
United Facility/Professional Professional Modifier Low / Median / High Price $34.59 / $45.83 / $75.39	Professional		$34.59	$45.83	$75.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.10 / $11.55 / $21.21	Professional	26	$9.10	$11.55	$21.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.87 / $34.28 / $62.39	Professional	TC	$23.87	$34.28	$62.39