Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.38 / $47.66 / $500.12	Facility		$33.38	$47.66	$500.12
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.06 / $30.09 / $36.11	Facility	26	$29.06	$30.09	$36.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.96 / $82.23 / $158.29	Professional		$46.96	$82.23	$158.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.22 / $45.34 / $96.52	Professional	26	$28.22	$45.34	$96.52
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.51 / $94.51 / $165.74	Professional	50	$94.51	$94.51	$165.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $35.15 / $45.95	Professional	TC	$16.98	$35.15	$45.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.75 / $59.69 / $437.00	Facility		$47.75	$59.69	$437.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.76 / $67.70 / $115.97	Professional		$44.76	$67.70	$115.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.25 / $38.78 / $55.48	Professional	26	$28.25	$38.78	$55.48
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $86.32 / $101.56 / $140.86	Professional	50	$86.32	$101.56	$140.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.51 / $28.92 / $50.81	Professional	TC	$16.51	$28.92	$50.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.44 / $203.39 / $670.85	Facility		$120.44	$203.39	$670.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.88 / $80.81 / $150.00	Professional		$48.88	$80.81	$150.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $44.32 / $75.34	Professional	26	$29.91	$44.32	$75.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.98 / $34.33 / $75.80	Professional	TC	$17.98	$34.33	$75.80
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.75 / $74.95 / $124.94	Professional		$0.75	$74.95	$124.94
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.34 / $41.45 / $60.06	Professional	26	$0.34	$41.45	$60.06
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.41 / $28.04 / $46.92	Professional	TC	$0.41	$28.04	$46.92
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $117.52 / $117.52 / $117.52	Facility		$117.52	$117.52	$117.52
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.75 / $46.15 / $73.02	Professional		$0.75	$46.15	$73.02
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.34 / $30.35 / $45.53	Professional	26	$0.34	$30.35	$45.53
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.41 / $18.32 / $27.50	Professional	TC	$0.41	$18.32	$27.50
United Facility/Professional Facility Modifier Low / Median / High Price $245.18 / $245.18 / $245.18	Facility		$245.18	$245.18	$245.18
United Facility/Professional Professional Modifier Low / Median / High Price $47.93 / $75.03 / $120.28	Professional		$47.93	$75.03	$120.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.06 / $34.68 / $67.77	Professional	26	$29.06	$34.68	$67.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $37.79 / $62.48	Professional	TC	$18.39	$37.79	$62.48