Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $208.93 / $489.78	Facility		$50.12	$208.93	$489.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $10.72 / $13.18	Facility	26	$10.00	$10.72	$13.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.90 / $199.53 / $467.74	Facility	TC	$30.90	$199.53	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $43.65 / $162.18	Professional		$33.11	$43.65	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.02 / $51.29	Professional	26	$8.91	$12.02	$51.29
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $38.02 / $120.23	Professional	50	$38.02	$38.02	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $32.36 / $63.10	Professional	TC	$23.99	$32.36	$63.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $30.90 / $41.69	Professional		$26.30	$30.90	$41.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $8.32 / $15.14	Professional	26	$7.08	$8.32	$15.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $29.51 / $64.57	Professional	TC	$19.05	$29.51	$64.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $54.95 / $54.95	Facility		$34.67	$54.95	$54.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $67.61	Professional		$38.90	$38.90	$67.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $10.23 / $17.78	Professional	26	$10.23	$10.23	$17.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $48.98 / $60.26 / $75.86	Professional	50	$48.98	$60.26	$75.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $28.84 / $50.12	Professional	TC	$28.84	$28.84	$50.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $204.17 / $549.54	Facility		$30.90	$204.17	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $45.71 / $77.62	Professional		$31.62	$45.71	$77.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $13.18 / $19.95	Professional	26	$9.12	$13.18	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $33.88 / $57.54	Professional	TC	$22.39	$33.88	$57.54
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.27 / $50.12 / $67.61	Professional		$0.27	$50.12	$67.61
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $12.88 / $16.98	Professional	26	$0.09	$12.88	$16.98
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.18 / $38.02 / $50.12	Professional	TC	$0.18	$38.02	$50.12
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.27 / $0.27 / $63.10	Professional		$0.27	$0.27	$63.10
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $0.09 / $15.85	Professional	26	$0.09	$0.09	$15.85
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.18 / $0.18 / $46.77	Professional	TC	$0.18	$0.18	$46.77
Select Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $41.69 / $41.69	Professional		$39.81	$41.69	$41.69
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $10.72 / $10.72	Professional	26	$10.23	$10.72	$10.72
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $30.90 / $30.90	Professional	TC	$29.51	$30.90	$30.90
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $40.74 / $67.61	Professional		$31.62	$40.74	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $11.48 / $19.05	Professional	26	$9.33	$11.48	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $28.84 / $50.12	Professional	TC	$22.39	$28.84	$50.12