Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.23 / $128.44 / $1,355.10	Facility		$98.23	$128.44	$1,355.10
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.83 / $15.28 / $18.34	Facility	26	$14.83	$15.28	$18.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $107.04 / $479.00	Professional		$81.59	$107.04	$479.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.19 / $16.54 / $86.00	Professional	26	$14.19	$16.54	$86.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.40 / $88.65 / $475.35	Professional	TC	$67.40	$88.65	$475.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $124.75 / $124.75 / $124.75	Professional		$124.75	$124.75	$124.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.84 / $27.51 / $27.51	Professional	26	$11.84	$27.51	$27.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.92 / $128.65 / $128.65	Facility		$102.92	$128.65	$128.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.09 / $94.17 / $126.25	Professional		$72.09	$94.17	$126.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.46 / $17.91 / $21.54	Professional	26	$9.46	$17.91	$21.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.62 / $77.43 / $108.33	Professional	TC	$62.62	$77.43	$108.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $254.54 / $462.32 / $1,417.79	Facility		$254.54	$462.32	$1,417.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.56 / $110.35 / $196.46	Professional		$74.56	$110.35	$196.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.07 / $20.39 / $28.35	Professional	26	$13.07	$20.39	$28.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.85 / $91.03 / $166.81	Professional	TC	$62.85	$91.03	$166.81
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.61 / $121.29 / $176.13	Professional		$0.61	$121.29	$176.13
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.20 / $19.16 / $24.94	Professional	26	$0.20	$19.16	$24.94
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.41 / $103.36 / $143.81	Professional	TC	$0.41	$103.36	$143.81
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $267.14 / $267.14 / $267.14	Facility		$267.14	$267.14	$267.14
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.61 / $98.23 / $158.21	Professional		$0.61	$98.23	$158.21
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.20 / $15.59 / $23.39	Professional	26	$0.20	$15.59	$23.39
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.41 / $89.88 / $134.82	Professional	TC	$0.41	$89.88	$134.82
United Facility/Professional Facility Modifier Low / Median / High Price $110.35 / $110.35 / $110.35	Facility		$110.35	$110.35	$110.35
United Facility/Professional Professional Modifier Low / Median / High Price $67.14 / $98.89 / $172.63	Professional		$67.14	$98.89	$172.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.22 / $16.60 / $30.71	Professional	26	$12.22	$16.60	$30.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.56 / $82.29 / $145.90	Professional	TC	$54.56	$82.29	$145.90