Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $426.58 / $831.76	Facility		$81.28	$426.58	$831.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $8.13 / $75.86	Facility	26	$7.94	$8.13	$75.86
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $53.70 / $190.55 / $575.44	Facility	TC	$53.70	$190.55	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $43.65 / $131.83	Professional		$14.79	$43.65	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.75 / $46.77	Professional	26	$7.08	$11.75	$46.77
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $29.51 / $89.13 / $199.53	Professional	50	$29.51	$89.13	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $36.31 / $107.15	Professional	TC	$21.38	$36.31	$107.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $25.70 / $38.02	Professional		$21.38	$25.70	$38.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $6.46 / $12.02	Professional	26	$5.89	$6.46	$12.02
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $32.36 / $38.02 / $43.65	Professional	50	$32.36	$38.02	$43.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $21.88 / $38.90	Professional	TC	$16.98	$21.88	$38.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $44.67 / $44.67	Facility		$28.18	$44.67	$44.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $32.36 / $54.95	Professional		$31.62	$32.36	$54.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $7.59 / $13.18	Professional	26	$7.41	$7.59	$13.18
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.90 / $47.86 / $61.66	Professional	50	$38.90	$47.86	$61.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $25.12 / $40.74	Professional	TC	$23.44	$25.12	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $169.82 / $416.87	Facility		$26.30	$169.82	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $38.02 / $64.57	Professional		$26.30	$38.02	$64.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $10.23 / $15.49	Professional	26	$6.76	$10.23	$15.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $26.92 / $50.12	Professional	TC	$19.05	$26.92	$50.12
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.24 / $40.74 / $54.95	Professional		$0.24	$40.74	$54.95
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.10 / $9.55 / $12.88	Professional	26	$0.10	$9.55	$12.88
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $30.90 / $41.69	Professional	TC	$0.14	$30.90	$41.69
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.24 / $0.24 / $51.29	Professional		$0.24	$0.24	$51.29
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.10 / $0.10 / $12.02	Professional	26	$0.10	$0.10	$12.02
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $0.14 / $38.90	Professional	TC	$0.14	$0.14	$38.90
Select Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $33.88 / $33.88	Professional		$33.11	$33.88	$33.88
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $7.94 / $7.94	Professional	26	$7.76	$7.94	$7.94
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $26.30 / $26.30	Professional	TC	$25.12	$26.30	$26.30
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $33.11 / $53.70	Professional		$22.91	$33.11	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $8.71 / $14.13	Professional	26	$6.31	$8.71	$14.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $24.55 / $40.74	Professional	TC	$16.60	$24.55	$40.74