Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $616.60 / $794.33	Facility		$97.72	$616.60	$794.33
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $8.51 / $81.28	Facility	26	$7.94	$8.51	$81.28
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $34.67 / $223.87 / $398.11	Facility	TC	$34.67	$223.87	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $41.69 / $138.04	Professional		$12.02	$41.69	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $13.18 / $46.77	Professional	26	$7.08	$13.18	$46.77
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.90 / $91.20 / $169.82	Professional	50	$30.90	$91.20	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $36.31 / $114.82	Professional	TC	$21.88	$36.31	$114.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $26.92 / $40.74	Professional		$22.91	$26.92	$40.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $6.76 / $13.18	Professional	26	$6.17	$6.76	$13.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $41.69 / $45.71	Professional	50	$36.31	$41.69	$45.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $22.91 / $42.66	Professional	TC	$18.62	$22.91	$42.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $48.98 / $48.98	Facility		$30.90	$48.98	$48.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $34.67 / $58.88	Professional		$33.11	$34.67	$58.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $7.94 / $13.80	Professional	26	$7.76	$7.94	$13.80
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $41.69 / $51.29 / $66.07	Professional	50	$41.69	$51.29	$66.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $26.92 / $43.65	Professional	TC	$23.99	$26.92	$43.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $169.82 / $416.87	Facility		$28.18	$169.82	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $38.02 / $67.61	Professional		$27.54	$38.02	$67.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.47 / $16.22	Professional	26	$6.92	$10.47	$16.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.84 / $53.70	Professional	TC	$19.95	$28.84	$53.70
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.25 / $44.67 / $58.88	Professional		$0.25	$44.67	$58.88
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $10.00 / $13.18	Professional	26	$0.09	$10.00	$13.18
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $34.67 / $45.71	Professional	TC	$0.16	$34.67	$45.71
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.25 / $0.25 / $54.95	Professional		$0.25	$0.25	$54.95
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $0.09 / $12.59	Professional	26	$0.09	$0.09	$12.59
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $0.16 / $42.66	Professional	TC	$0.16	$0.16	$42.66
Select Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $37.15 / $37.15	Professional		$35.48	$37.15	$37.15
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.32 / $8.32	Professional	26	$7.94	$8.32	$8.32
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $28.84 / $28.84	Professional	TC	$26.92	$28.84	$28.84
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $35.48 / $57.54	Professional		$23.44	$35.48	$57.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $9.12 / $14.79	Professional	26	$6.31	$9.12	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $26.30 / $42.66	Professional	TC	$16.60	$26.30	$42.66