Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.62 / $204.16 / $612.82	Facility		$42.62	$204.16	$612.82
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 $30.66 / $92.83 / $469.22	Facility	TC	$30.66	$92.83	$469.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.95 / $45.85 / $168.02	Professional		$35.95	$45.85	$168.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.36 / $14.37 / $63.96	Professional	26	$10.36	$14.37	$63.96
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.28 / $38.28 / $38.28	Professional	50	$38.28	$38.28	$38.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.57 / $30.66 / $160.00	Professional	TC	$25.57	$30.66	$160.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.78 / $39.21 / $70.98	Professional		$30.78	$39.21	$70.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.24 / $15.24 / $18.97	Professional	26	$8.24	$15.24	$18.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.77 / $52.21 / $52.21	Facility		$41.77	$52.21	$52.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.54 / $44.18 / $66.51	Professional		$37.54	$44.18	$66.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $12.50 / $17.62	Professional	26	$9.44	$12.50	$17.62
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $50.81 / $57.73 / $75.00	Professional	50	$50.81	$57.73	$75.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.96 / $32.26 / $48.57	Professional	TC	$26.96	$32.26	$48.57
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 $31.73 / $48.11 / $77.12	Professional		$31.73	$48.11	$77.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.21 / $14.12 / $20.22	Professional	26	$9.21	$14.12	$20.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.52 / $34.65 / $56.90	Professional	TC	$22.52	$34.65	$56.90
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.27 / $50.41 / $70.16	Professional		$0.27	$50.41	$70.16
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $13.30 / $17.77	Professional	26	$0.09	$13.30	$17.77
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.18 / $37.15 / $50.19	Professional	TC	$0.18	$37.15	$50.19
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 $0.27 / $40.01 / $63.02	Professional		$0.27	$40.01	$63.02
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 / $31.37 / $47.06	Professional	TC	$0.18	$31.37	$47.06
United Facility/Professional Professional Modifier Low / Median / High Price $31.55 / $40.42 / $72.15	Professional		$31.55	$40.42	$72.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.38 / $11.55 / $21.37	Professional	26	$9.38	$11.55	$21.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.97 / $28.87 / $52.54	Professional	TC	$22.97	$28.87	$52.54