Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.41 / $170.68 / $206.42	Facility		$142.41	$170.68	$206.42
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.17 / $84.79 / $101.75	Facility	26	$77.17	$84.79	$101.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.66 / $211.53 / $335.62	Professional		$142.66	$211.53	$335.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $83.79 / $290.00	Professional	26	$48.86	$83.79	$290.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $71.33 / $77.37 / $464.91	Professional	52	$71.33	$77.37	$464.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.34 / $162.66 / $348.12	Professional	TC	$69.34	$162.66	$348.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.99 / $113.99 / $113.99	Professional		$113.99	$113.99	$113.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.58 / $114.21 / $114.21	Professional	26	$64.58	$114.21	$114.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.93 / $183.66 / $183.66	Facility		$146.93	$183.66	$183.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.51 / $179.77 / $242.10	Professional		$143.51	$179.77	$242.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.53 / $77.47 / $101.33	Professional	26	$54.53	$77.47	$101.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.04 / $84.35 / $182.83	Professional	TC	$66.04	$84.35	$182.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,166.76 / $6,020.05 / $17,638.84	Facility		$3,166.76	$6,020.05	$17,638.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.41 / $247.25 / $601.07	Professional		$137.41	$247.25	$601.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.82 / $82.55 / $144.22	Professional	26	$44.82	$82.55	$144.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.80 / $130.27 / $549.34	Professional	TC	$68.80	$130.27	$549.34
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.08 / $192.39 / $249.85	Professional		$1.08	$192.39	$249.85
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.27 / $87.15 / $126.77	Professional	26	$0.27	$87.15	$126.77
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.81 / $101.76 / $163.79	Professional	TC	$0.81	$101.76	$163.79
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $3,478.55 / $3,478.55 / $3,478.55	Facility		$3,478.55	$3,478.55	$3,478.55
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.08 / $142.41 / $221.99	Professional		$1.08	$142.41	$221.99
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.27 / $79.23 / $118.85	Professional	26	$0.27	$79.23	$118.85
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.81 / $68.76 / $103.14	Professional	TC	$0.81	$68.76	$103.14
United Facility/Professional Professional Modifier Low / Median / High Price $145.30 / $208.65 / $555.58	Professional		$145.30	$208.65	$555.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.68 / $84.08 / $144.55	Professional	26	$42.68	$84.08	$144.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.25 / $108.13 / $413.07	Professional	TC	$75.25	$108.13	$413.07