Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.94 / $381.93 / $672.97	Facility		$71.94	$381.93	$672.97
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.71 / $9.05 / $9.84	Facility	26	$7.71	$9.05	$9.84
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.01 / $95.73 / $379.33	Facility	TC	$29.01	$95.73	$379.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.26 / $39.00 / $152.00	Professional		$9.26	$39.00	$152.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.58 / $9.26 / $45.96	Professional	26	$7.58	$9.26	$45.96
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $208.50 / $208.50 / $208.50	Professional	50	$208.50	$208.50	$208.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.90 / $17.55 / $96.53	Professional	52	$15.90	$17.55	$96.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.05 / $32.36 / $145.26	Professional	TC	$22.05	$32.36	$145.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.17 / $26.31 / $32.22	Professional		$22.17	$26.31	$32.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $11.41 / $16.80	Professional	26	$6.17	$11.41	$16.80
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $39.47 / $39.47 / $48.33	Professional	50	$39.47	$39.47	$48.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.36 / $42.95 / $42.95	Facility		$34.36	$42.95	$42.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.62 / $31.76 / $43.00	Professional		$29.62	$31.76	$43.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $9.30 / $11.40	Professional	26	$6.74	$9.30	$11.40
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.65 / $46.54 / $62.41	Professional	50	$39.65	$46.54	$62.41
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.04 / $24.02 / $32.20	Professional	TC	$21.04	$24.02	$32.20
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 $26.38 / $38.42 / $64.02	Professional		$26.38	$38.42	$64.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $10.75 / $15.22	Professional	26	$7.85	$10.75	$15.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.83 / $48.81	Professional	TC	$19.05	$28.83	$48.81
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.23 / $41.18 / $57.31	Professional		$0.23	$41.18	$57.31
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.08 / $10.35 / $13.44	Professional	26	$0.08	$10.35	$13.44
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $30.31 / $42.18	Professional	TC	$0.14	$30.31	$42.18
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 $0.23 / $32.89 / $51.48	Professional		$0.23	$32.89	$51.48
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.08 / $7.96 / $11.94	Professional	26	$0.08	$7.96	$11.94
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $26.36 / $39.54	Professional	TC	$0.14	$26.36	$39.54
United Facility/Professional Professional Modifier Low / Median / High Price $23.60 / $33.92 / $57.77	Professional		$23.60	$33.92	$57.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.34 / $8.67 / $63.77	Professional	26	$6.34	$8.67	$63.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.92 / $25.26 / $41.68	Professional	TC	$15.92	$25.26	$41.68