Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $398.11 / $758.58	Facility		$75.86	$398.11	$758.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $8.71 / $72.44	Facility	26	$7.08	$8.71	$72.44
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.84 / $165.96 / $398.11	Facility	TC	$28.84	$165.96	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $36.31 / $112.20	Professional		$14.13	$36.31	$112.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.96 / $43.65	Professional	26	$6.03	$10.96	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $77.62 / $112.20	Professional	50	$52.48	$77.62	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $25.70 / $75.86	Professional	TC	$17.78	$25.70	$75.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $23.44 / $30.90	Professional		$19.50	$23.44	$30.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $6.17 / $11.22	Professional	26	$5.75	$6.17	$11.22
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.15 / $37.15 / $37.15	Professional	50	$37.15	$37.15	$37.15
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $21.88 / $34.67	Professional	TC	$15.85	$21.88	$34.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $40.74 / $40.74	Facility		$25.70	$40.74	$40.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $29.51 / $51.29	Professional		$28.84	$29.51	$51.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $7.24 / $12.59	Professional	26	$7.08	$7.24	$12.59
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $35.48 / $43.65 / $57.54	Professional	50	$35.48	$43.65	$57.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $22.39 / $38.02	Professional	TC	$19.50	$22.39	$38.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $169.82 / $416.87	Facility		$23.99	$169.82	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.88 / $60.26	Professional		$23.99	$33.88	$60.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.23 / $14.79	Professional	26	$6.92	$10.23	$14.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $24.55 / $46.77	Professional	TC	$16.60	$24.55	$46.77
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.23 / $37.15 / $50.12	Professional		$0.23	$37.15	$50.12
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.07 / $9.12 / $12.30	Professional	26	$0.07	$9.12	$12.30
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.15 / $28.18 / $38.02	Professional	TC	$0.15	$28.18	$38.02
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.23 / $0.23 / $46.77	Professional		$0.23	$0.23	$46.77
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.07 / $0.07 / $11.48	Professional	26	$0.07	$0.07	$11.48
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.15 / $0.15 / $35.48	Professional	TC	$0.15	$0.15	$35.48
Select Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $31.62 / $31.62	Professional		$30.90	$31.62	$31.62
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $7.59 / $7.59	Professional	26	$7.41	$7.59	$7.59
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $23.44 / $23.44	Professional	TC	$23.44	$23.44	$23.44
United Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $30.90 / $50.12	Professional		$20.89	$30.90	$50.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $8.32 / $13.49	Professional	26	$6.31	$8.32	$13.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $22.91 / $37.15	Professional	TC	$14.79	$22.91	$37.15