Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.88 / $523.53 / $607.50	Facility		$75.88	$523.53	$607.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.39 / $7.87 / $9.44	Facility	26	$7.39	$7.87	$9.44
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.16 / $75.88 / $227.52	Facility	TC	$27.16	$75.88	$227.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.50 / $35.84 / $182.63	Professional		$17.50	$35.84	$182.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.48 / $11.72 / $46.55	Professional	26	$7.48	$11.72	$46.55
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $111.19 / $111.19 / $111.19	Professional	50	$111.19	$111.19	$111.19
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.99 / $16.53 / $91.32	Professional	52	$14.99	$16.53	$91.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $24.62 / $45.59	Professional	TC	$18.53	$24.62	$45.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.87 / $24.76 / $30.33	Professional		$23.87	$24.76	$30.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.98 / $11.45 / $13.54	Professional	26	$5.98	$11.45	$13.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $32.32 / $40.40 / $40.40	Facility		$32.32	$40.40	$40.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.09 / $29.84 / $39.19	Professional		$28.09	$29.84	$39.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.44 / $8.31 / $10.90	Professional	26	$6.44	$8.31	$10.90
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.32 / $43.81 / $58.78	Professional	50	$37.32	$43.81	$58.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.23 / $21.83 / $30.16	Professional	TC	$20.23	$21.83	$30.16
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 $24.86 / $35.76 / $60.29	Professional		$24.86	$35.76	$60.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $10.03 / $14.60	Professional	26	$6.71	$10.03	$14.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $27.04 / $45.69	Professional	TC	$18.20	$27.04	$45.69
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.21 / $38.77 / $53.96	Professional		$0.21	$38.77	$53.96
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.07 / $9.94 / $12.74	Professional	26	$0.07	$9.94	$12.74
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $28.88 / $38.96	Professional	TC	$0.14	$28.88	$38.96
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 $0.21 / $30.95 / $48.47	Professional		$0.21	$30.95	$48.47
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.07 / $7.96 / $11.94	Professional	26	$0.07	$7.96	$11.94
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $24.35 / $36.53	Professional	TC	$0.14	$24.35	$36.53
United Facility/Professional Facility Modifier Low / Median / High Price $182.03 / $182.03 / $182.03	Facility		$182.03	$182.03	$182.03
United Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $32.11 / $54.71	Professional		$21.88	$32.11	$54.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.08 / $8.66 / $15.21	Professional	26	$6.08	$8.66	$15.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.77 / $23.46 / $38.71	Professional	TC	$14.77	$23.46	$38.71