Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $76.20 / $497.20 / $737.43	Facility		$76.20	$497.20	$737.43
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.07 / $8.31 / $9.03	Facility	26	$7.07	$8.31	$9.03
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.08 / $65.59 / $236.88	Facility	TC	$23.08	$65.59	$236.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.63 / $39.65 / $160.09	Professional		$26.63	$39.65	$160.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.12 / $16.45 / $42.47	Professional	26	$7.12	$16.45	$42.47
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.65 / $15.70 / $270.98	Professional	52	$13.65	$15.70	$270.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $21.92 / $74.76	Professional	TC	$17.89	$21.92	$74.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.20 / $21.91 / $48.48	Professional		$21.20	$21.91	$48.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.74 / $10.46 / $10.96	Professional	26	$5.74	$10.46	$10.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.57 / $35.71 / $35.71	Facility		$28.57	$35.71	$35.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.75 / $27.75 / $34.68	Professional		$24.75	$27.75	$34.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.14 / $8.31 / $10.53	Professional	26	$6.14	$8.31	$10.53
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $32.67 / $38.79 / $52.03	Professional	50	$32.67	$38.79	$52.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.60 / $19.68 / $26.09	Professional	TC	$18.60	$19.68	$26.09
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 $23.47 / $33.20 / $52.81	Professional		$23.47	$33.20	$52.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.13 / $9.81 / $13.97	Professional	26	$6.13	$9.81	$13.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.16 / $24.22 / $39.64	Professional	TC	$16.16	$24.22	$39.64
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.21 / $35.79 / $47.83	Professional		$0.21	$35.79	$47.83
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.08 / $9.19 / $12.21	Professional	26	$0.08	$9.19	$12.21
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.13 / $26.26 / $33.61	Professional	TC	$0.13	$26.26	$33.61
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 / $27.39 / $42.96	Professional		$0.21	$27.39	$42.96
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.08 / $7.63 / $11.45	Professional	26	$0.08	$7.63	$11.45
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.13 / $21.01 / $31.52	Professional	TC	$0.13	$21.01	$31.52
United Facility/Professional Professional Modifier Low / Median / High Price $20.80 / $28.15 / $51.23	Professional		$20.80	$28.15	$51.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.09 / $7.94 / $14.41	Professional	26	$6.09	$7.94	$14.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.04 / $20.21 / $36.71	Professional	TC	$15.04	$20.21	$36.71