Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $120.23 / $199.53	Facility		$35.48	$120.23	$199.53
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $30.20 / $36.31	Facility	26	$30.20	$30.20	$36.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $83.18 / $173.78	Professional		$43.65	$83.18	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $44.67 / $186.21	Professional	26	$25.70	$44.67	$186.21
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $165.96 / $467.74	Professional	50	$52.48	$165.96	$467.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $22.91 / $47.86	Professional	TC	$14.13	$22.91	$47.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $38.02 / $61.66	Professional		$32.36	$38.02	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $19.95 / $19.95	Professional	26	$19.95	$19.95	$19.95
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $46.77 / $51.29 / $60.26	Professional	50	$46.77	$51.29	$60.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $63.10 / $63.10	Facility		$39.81	$63.10	$63.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $63.10 / $120.23	Professional		$44.67	$63.10	$120.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.02 / $54.95	Professional	26	$28.18	$38.02	$54.95
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $75.86 / $81.28 / $138.04	Professional	50	$75.86	$81.28	$138.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $25.12 / $77.62	Professional	TC	$16.60	$25.12	$77.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $204.17 / $549.54	Facility		$17.78	$204.17	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $83.18 / $158.49	Professional		$54.95	$83.18	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $46.77 / $75.86	Professional	26	$30.90	$46.77	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $34.67 / $77.62	Professional	TC	$20.42	$34.67	$77.62
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.76 / $58.88 / $95.50	Professional		$0.76	$58.88	$95.50
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.34 / $36.31 / $54.95	Professional	26	$0.34	$36.31	$54.95
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.41 / $21.88 / $39.81	Professional	TC	$0.41	$21.88	$39.81
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.76 / $0.76 / $72.44	Professional		$0.76	$0.76	$72.44
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.34 / $0.34 / $45.71	Professional	26	$0.34	$0.34	$45.71
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.41 / $0.41 / $27.54	Professional	TC	$0.41	$0.41	$27.54
Select Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $48.98 / $66.07	Professional		$45.71	$48.98	$66.07
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $30.20 / $42.66	Professional	26	$28.84	$30.20	$42.66
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $18.20 / $23.99	Professional	TC	$16.98	$18.20	$23.99
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $75.86 / $125.89	Professional		$46.77	$75.86	$125.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $34.67 / $61.66	Professional	26	$27.54	$34.67	$61.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $35.48 / $64.57	Professional	TC	$17.38	$35.48	$64.57