Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.87 / $434.70 / $770.50	Facility		$92.87	$434.70	$770.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.68 / $10.16 / $95.33	Facility	26	$8.68	$10.16	$95.33
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $57.70 / $180.48 / $685.36	Facility	TC	$57.70	$180.48	$685.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.48 / $51.02 / $189.94	Professional		$10.48	$51.02	$189.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $13.95 / $53.86	Professional	26	$9.19	$13.95	$53.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.27 / $73.68 / $249.00	Professional	50	$19.27	$73.68	$249.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $18.96 / $21.01 / $113.15	Professional	52	$18.96	$21.01	$113.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.10 / $43.36 / $172.43	Professional	TC	$27.10	$43.36	$172.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.23 / $49.99 / $69.64	Professional		$30.23	$49.99	$69.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.86 / $12.85 / $19.27	Professional	26	$6.86	$12.85	$19.27
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $45.34 / $47.23 / $57.81	Professional	50	$45.34	$47.23	$57.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.40 / $37.40 / $37.40	Professional	TC	$37.40	$37.40	$37.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.15 / $51.44 / $51.44	Facility		$41.15	$51.44	$51.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.04 / $37.07 / $49.69	Professional		$35.04	$37.07	$49.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.53 / $10.08 / $12.30	Professional	26	$7.53	$10.08	$12.30
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $47.31 / $54.93 / $74.54	Professional	50	$47.31	$54.93	$74.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.25 / $29.18 / $39.11	Professional	TC	$26.25	$29.18	$39.11
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 $31.51 / $44.92 / $76.48	Professional		$31.51	$44.92	$76.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.19 / $11.85 / $17.09	Professional	26	$8.19	$11.85	$17.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.83 / $34.95 / $59.40	Professional	TC	$22.83	$34.95	$59.40
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.25 / $50.81 / $70.70	Professional		$0.25	$50.81	$70.70
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $11.63 / $15.39	Professional	26	$0.09	$11.63	$15.39
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $38.78 / $52.86	Professional	TC	$0.16	$38.78	$52.86
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 / $39.36 / $63.51	Professional		$0.25	$39.36	$63.51
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $9.30 / $13.95	Professional	26	$0.09	$9.30	$13.95
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $33.04 / $49.56	Professional	TC	$0.16	$33.04	$49.56
United Facility/Professional Professional Modifier Low / Median / High Price $25.98 / $39.70 / $67.65	Professional		$25.98	$39.70	$67.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $9.74 / $17.73	Professional	26	$7.50	$9.74	$17.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $29.96 / $50.17	Professional	TC	$19.46	$29.96	$50.17