Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $331.13 / $691.83	Facility		$69.18	$331.13	$691.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $9.77 / $60.26	Facility	26	$7.94	$9.77	$60.26
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $43.65 / $100.00 / $380.19	Facility	TC	$43.65	$100.00	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $34.67 / $112.20	Professional		$23.99	$34.67	$112.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.23 / $39.81	Professional	26	$7.08	$10.23	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $21.88 / $47.86	Professional	TC	$15.85	$21.88	$47.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $22.39 / $29.51	Professional		$18.62	$22.39	$29.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $7.24 / $12.88	Professional	26	$6.46	$7.24	$12.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $16.22 / $30.90	Professional	TC	$14.13	$16.22	$30.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $38.90 / $38.90	Facility		$24.55	$38.90	$38.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $28.84 / $48.98	Professional		$24.55	$28.84	$48.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $8.32 / $14.45	Professional	26	$7.41	$8.32	$14.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $20.42 / $33.88	Professional	TC	$16.60	$20.42	$33.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $169.82 / $416.87	Facility		$21.88	$169.82	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $32.36 / $56.23	Professional		$21.88	$32.36	$56.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $10.47 / $16.22	Professional	26	$7.24	$10.47	$16.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $22.39 / $39.81	Professional	TC	$15.49	$22.39	$39.81
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.23 / $35.48 / $47.86	Professional		$0.23	$35.48	$47.86
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $10.47 / $13.80	Professional	26	$0.09	$10.47	$13.80
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $25.12 / $33.88	Professional	TC	$0.14	$25.12	$33.88
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.23 / $0.23 / $44.67	Professional		$0.23	$0.23	$44.67
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $0.09 / $12.88	Professional	26	$0.09	$0.09	$12.88
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.14 / $0.14 / $31.62	Professional	TC	$0.14	$0.14	$31.62
Select Health Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $29.51 / $29.51	Professional		$28.84	$29.51	$29.51
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $8.71 / $8.71	Professional	26	$8.32	$8.71	$8.71
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $20.89 / $20.89	Professional	TC	$20.42	$20.89	$20.89
United Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $29.51 / $48.98	Professional		$21.88	$29.51	$48.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.33 / $15.49	Professional	26	$7.41	$9.33	$15.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $20.42 / $33.11	Professional	TC	$14.45	$20.42	$33.11