Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.54 / $682.80 / $1,273.55	Facility		$125.54	$682.80	$1,273.55
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.73 / $27.76 / $33.31	Facility	26	$25.73	$27.76	$33.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.34 / $130.51 / $597.10	Professional		$107.34	$130.51	$597.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.28 / $35.72 / $148.72	Professional	26	$24.28	$35.72	$148.72
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $50.10 / $56.91 / $337.21	Professional	52	$50.10	$56.91	$337.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.28 / $94.92 / $501.61	Professional	TC	$83.28	$94.92	$501.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.68 / $84.68 / $160.88	Professional		$84.68	$84.68	$160.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.58 / $37.82 / $50.62	Professional	26	$20.58	$37.82	$50.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $97.68 / $97.68 / $97.68	Professional	TC	$97.68	$97.68	$97.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $110.54 / $138.18 / $437.00	Facility		$110.54	$138.18	$437.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.13 / $106.99 / $151.65	Professional		$105.13	$106.99	$151.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.71 / $25.98 / $38.51	Professional	26	$25.71	$25.98	$38.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.15 / $81.28 / $113.53	Professional	TC	$79.15	$81.28	$113.53
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 $81.58 / $126.29 / $211.19	Professional		$81.58	$126.29	$211.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.31 / $34.50 / $51.45	Professional	26	$22.31	$34.50	$51.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.28 / $96.41 / $159.68	Professional	TC	$62.28	$96.41	$159.68
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.67 / $130.44 / $195.66	Professional		$0.67	$130.44	$195.66
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.31 / $31.48 / $44.28	Professional	26	$0.31	$31.48	$44.28
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.36 / $98.96 / $139.55	Professional	TC	$0.36	$98.96	$139.55
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 $0.67 / $105.84 / $163.05	Professional		$0.67	$105.84	$163.05
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.31 / $26.23 / $39.35	Professional	26	$0.31	$26.23	$39.35
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.36 / $82.47 / $123.71	Professional	TC	$0.36	$82.47	$123.71
United Facility/Professional Facility Modifier Low / Median / High Price $117.33 / $117.33 / $243.10	Facility		$117.33	$117.33	$243.10
United Facility/Professional Professional Modifier Low / Median / High Price $79.98 / $118.01 / $207.48	Professional		$79.98	$118.01	$207.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.61 / $28.87 / $47.20	Professional	26	$19.61	$28.87	$47.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.98 / $89.14 / $145.72	Professional	TC	$57.98	$89.14	$145.72