Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.69 / $525.25 / $850.34	Facility		$94.69	$525.25	$850.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.71 / $9.05 / $75.28	Facility	26	$7.71	$9.05	$75.28
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.97 / $194.41 / $791.64	Facility	TC	$31.97	$194.41	$791.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.57 / $46.91 / $144.31	Professional		$18.57	$46.91	$144.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $13.61 / $47.69	Professional	26	$7.78	$13.61	$47.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $63.78 / $113.29 / $121.31	Professional	50	$63.78	$113.29	$121.31
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.91 / $17.57 / $94.40	Professional	52	$15.91	$17.57	$94.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.00 / $44.31 / $126.00	Professional	TC	$24.00	$44.31	$126.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.35 / $32.22 / $58.20	Professional		$25.35	$32.22	$58.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $11.41 / $16.80	Professional	26	$6.17	$11.41	$16.80
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $39.47 / $48.35	Professional	50	$38.02	$39.47	$48.35
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.70 / $30.70 / $30.70	Professional	TC	$30.70	$30.70	$30.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.35 / $42.94 / $42.94	Facility		$34.35	$42.94	$42.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.30 / $32.70 / $41.58	Professional		$30.30	$32.70	$41.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.69 / $9.09 / $11.40	Professional	26	$6.69	$9.09	$11.40
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.99 / $46.09 / $62.37	Professional	50	$39.99	$46.09	$62.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.15 / $23.90 / $32.20	Professional	TC	$22.15	$23.90	$32.20
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 $25.02 / $38.32 / $64.65	Professional		$25.02	$38.32	$64.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.69 / $10.66 / $15.43	Professional	26	$6.69	$10.66	$15.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.93 / $28.09 / $49.50	Professional	TC	$19.93	$28.09	$49.50
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.24 / $41.21 / $56.76	Professional		$0.24	$41.21	$56.76
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.10 / $9.94 / $12.74	Professional	26	$0.10	$9.94	$12.74
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $31.22 / $41.63	Professional	TC	$0.14	$31.22	$41.63
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 $0.24 / $32.89 / $50.99	Professional		$0.24	$32.89	$50.99
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.10 / $7.96 / $11.94	Professional	26	$0.10	$7.96	$11.94
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $26.02 / $39.03	Professional	TC	$0.14	$26.02	$39.03
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 $24.00 / $33.20 / $60.42	Professional		$24.00	$33.20	$60.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.39 / $8.66 / $15.76	Professional	26	$6.39	$8.66	$15.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.92 / $24.54 / $44.66	Professional	TC	$16.92	$24.54	$44.66