Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $323.59 / $776.25	Facility		$57.54	$323.59	$776.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $8.91 / $95.50	Facility	26	$8.91	$8.91	$95.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $57.54 / $218.78 / $691.83	Facility	TC	$57.54	$218.78	$691.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $48.98 / $173.78	Professional		$17.38	$48.98	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $14.13 / $53.70	Professional	26	$7.94	$14.13	$53.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.05 / $104.71 / $251.19	Professional	50	$19.05	$104.71	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $37.15 / $102.33	Professional	TC	$24.55	$37.15	$102.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $30.90 / $44.67	Professional		$25.12	$30.90	$44.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $7.59 / $14.13	Professional	26	$6.61	$7.59	$14.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $39.81 / $43.65 / $51.29	Professional	50	$39.81	$43.65	$51.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $25.70 / $50.12	Professional	TC	$19.95	$25.70	$50.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $56.23 / $56.23	Facility		$34.67	$56.23	$56.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $38.90 / $66.07	Professional		$36.31	$38.90	$66.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $8.51 / $14.79	Professional	26	$8.32	$8.51	$14.79
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $45.71 / $56.23 / $74.13	Professional	50	$45.71	$56.23	$74.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $30.20 / $48.98	Professional	TC	$26.30	$30.20	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $169.82 / $416.87	Facility		$31.62	$169.82	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $42.66 / $70.79	Professional		$30.20	$42.66	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $11.48 / $16.98	Professional	26	$8.13	$11.48	$16.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $31.62 / $60.26	Professional	TC	$21.88	$31.62	$60.26
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.25 / $51.29 / $67.61	Professional		$0.25	$51.29	$67.61
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $11.22 / $14.79	Professional	26	$0.09	$11.22	$14.79
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $39.81 / $52.48	Professional	TC	$0.16	$39.81	$52.48
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.25 / $0.25 / $63.10	Professional		$0.25	$0.25	$63.10
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $0.09 / $13.80	Professional	26	$0.09	$0.09	$13.80
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $0.16 / $50.12	Professional	TC	$0.16	$0.16	$50.12
Select Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $42.66 / $42.66	Professional		$39.81	$42.66	$42.66
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $9.33 / $9.33	Professional	26	$8.71	$9.33	$9.33
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $33.11 / $33.11	Professional	TC	$30.90	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $39.81 / $64.57	Professional		$25.70	$39.81	$64.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.77 / $15.85	Professional	26	$6.61	$9.77	$15.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $30.20 / $48.98	Professional	TC	$18.62	$30.20	$48.98