Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.80 / $498.07 / $764.00	Facility		$75.80	$498.07	$764.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.39 / $8.67 / $72.93	Facility	26	$7.39	$8.67	$72.93
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.42 / $158.74 / $395.82	Facility	TC	$26.42	$158.74	$395.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.61 / $36.96 / $163.00	Professional		$13.61	$36.96	$163.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.49 / $10.88 / $44.51	Professional	26	$7.49	$10.88	$44.51
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $55.28 / $55.28 / $112.62	Professional	50	$55.28	$55.28	$112.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.59 / $33.46 / $122.00	Professional	TC	$17.59	$33.46	$122.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.68 / $24.50 / $54.16	Professional		$20.68	$24.50	$54.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.91 / $10.94 / $16.10	Professional	26	$5.91	$10.94	$16.10
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $35.44 / $35.44 / $35.44	Professional	50	$35.44	$35.44	$35.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.98 / $39.97 / $39.97	Facility		$31.98	$39.97	$39.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.69 / $29.10 / $38.35	Professional		$27.69	$29.10	$38.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.44 / $8.99 / $11.03	Professional	26	$6.44	$8.99	$11.03
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $36.54 / $42.90 / $57.52	Professional	50	$36.54	$42.90	$57.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.44 / $21.66 / $29.35	Professional	TC	$19.44	$21.66	$29.35
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 $23.74 / $36.25 / $59.73	Professional		$23.74	$36.25	$59.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.98 / $10.46 / $14.78	Professional	26	$6.98	$10.46	$14.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.76 / $26.31 / $44.45	Professional	TC	$16.76	$26.31	$44.45
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.23 / $37.53 / $52.29	Professional		$0.23	$37.53	$52.29
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.07 / $9.59 / $12.74	Professional	26	$0.07	$9.59	$12.74
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.15 / $27.23 / $37.89	Professional	TC	$0.15	$27.23	$37.89
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 / $30.63 / $46.97	Professional		$0.23	$30.63	$46.97
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.07 / $7.63 / $11.45	Professional	26	$0.07	$7.63	$11.45
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.15 / $23.68 / $35.52	Professional	TC	$0.15	$23.68	$35.52
United Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $31.04 / $54.19	Professional		$26.51	$31.04	$54.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.34 / $8.30 / $15.11	Professional	26	$6.34	$8.30	$15.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.78 / $22.74 / $39.51	Professional	TC	$14.78	$22.74	$39.51