Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $193.98 / $564.33 / $641.41	Facility		$193.98	$564.33	$641.41
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.36 / $8.88 / $10.66	Facility	26	$8.36	$8.88	$10.66
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.38 / $96.95 / $379.33	Facility	TC	$29.38	$96.95	$379.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.97 / $43.26 / $193.00	Professional		$9.97	$43.26	$193.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.82 / $12.93 / $50.42	Professional	26	$8.82	$12.93	$50.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.53 / $29.29 / $132.00	Professional	TC	$22.53	$29.29	$132.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.25 / $52.46 / $65.02	Professional		$23.25	$52.46	$65.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.31 / $12.37 / $15.36	Professional	26	$8.31	$12.37	$15.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.04 / $45.05 / $45.05	Facility		$36.04	$45.05	$45.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.21 / $38.46 / $53.91	Professional		$32.21	$38.46	$53.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.74 / $10.16 / $14.35	Professional	26	$7.74	$10.16	$14.35
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $43.57 / $49.51 / $64.77	Professional	50	$43.57	$49.51	$64.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.54 / $28.06 / $39.28	Professional	TC	$23.54	$28.06	$39.28
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 $26.03 / $40.27 / $65.90	Professional		$26.03	$40.27	$65.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.54 / $11.56 / $16.47	Professional	26	$7.54	$11.56	$16.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $29.74 / $49.43	Professional	TC	$18.48	$29.74	$49.43
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.25 / $42.40 / $59.55	Professional		$0.25	$42.40	$59.55
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $10.84 / $14.41	Professional	26	$0.09	$10.84	$14.41
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $31.08 / $43.25	Professional	TC	$0.16	$31.08	$43.25
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 / $34.51 / $53.49	Professional		$0.25	$34.51	$53.49
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 / $27.03 / $40.54	Professional	TC	$0.16	$27.03	$40.54
United Facility/Professional Professional Modifier Low / Median / High Price $26.72 / $35.01 / $63.72	Professional		$26.72	$35.01	$63.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.67 / $9.39 / $17.19	Professional	26	$7.67	$9.39	$17.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.12 / $25.63 / $46.65	Professional	TC	$19.12	$25.63	$46.65