Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.90 / $341.44 / $701.18	Facility		$98.90	$341.44	$701.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.36 / $9.77 / $60.30	Facility	26	$8.36	$9.77	$60.30
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.92 / $98.90 / $379.33	Facility	TC	$25.92	$98.90	$379.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.71 / $47.85 / $115.98	Professional		$26.71	$47.85	$115.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.49 / $9.97 / $39.90	Professional	26	$8.49	$9.97	$39.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $24.07 / $102.00	Professional	TC	$17.57	$24.07	$102.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.21 / $44.10 / $51.42	Professional		$23.21	$44.10	$51.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.69 / $12.71 / $18.22	Professional	26	$6.69	$12.71	$18.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.19 / $25.19 / $25.19	Professional	TC	$25.19	$25.19	$25.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.25 / $37.81 / $37.81	Facility		$30.25	$37.81	$37.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.51 / $31.16 / $44.00	Professional		$20.51	$31.16	$44.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.61 / $9.28 / $13.75	Professional	26	$5.61	$9.28	$13.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.89 / $22.52 / $30.64	Professional	TC	$14.89	$22.52	$30.64
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 $21.99 / $34.04 / $56.56	Professional		$21.99	$34.04	$56.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $11.18 / $16.47	Professional	26	$7.25	$11.18	$16.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.74 / $23.74 / $40.08	Professional	TC	$14.74	$23.74	$40.08
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.23 / $35.03 / $49.50	Professional		$0.23	$35.03	$49.50
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $10.79 / $14.07	Professional	26	$0.09	$10.79	$14.07
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $24.16 / $33.61	Professional	TC	$0.14	$24.16	$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 $0.23 / $29.01 / $44.46	Professional		$0.23	$29.01	$44.46
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $8.63 / $12.95	Professional	26	$0.09	$8.63	$12.95
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $21.01 / $31.52	Professional	TC	$0.14	$21.01	$31.52
United Facility/Professional Professional Modifier Low / Median / High Price $22.72 / $29.59 / $51.65	Professional		$22.72	$29.59	$51.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.39 / $9.46 / $69.31	Professional	26	$7.39	$9.46	$69.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $20.21 / $33.35	Professional	TC	$15.14	$20.21	$33.35