Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.97 / $190.51 / $488.80	Facility		$85.97	$190.51	$488.80
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.17 / $32.81 / $39.36	Facility	26	$31.17	$32.81	$39.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.01 / $94.37 / $444.00	Professional		$81.01	$94.37	$444.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.44 / $74.04 / $169.84	Professional	26	$30.44	$74.04	$169.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $111.06 / $528.51 / $637.50	Professional	50	$111.06	$528.51	$637.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.37 / $58.14 / $306.32	Professional	TC	$50.37	$58.14	$306.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.52 / $80.45 / $124.50	Professional		$63.52	$80.45	$124.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.06 / $30.99 / $67.92	Professional	26	$24.06	$30.99	$67.92
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $98.29 / $120.69 / $186.75	Professional	50	$98.29	$120.69	$186.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.16 / $106.45 / $437.00	Facility		$85.16	$106.45	$437.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.64 / $93.98 / $148.44	Professional		$80.64	$93.98	$148.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.48 / $34.18 / $52.91	Professional	26	$30.48	$34.18	$52.91
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $119.83 / $137.84 / $156.63	Professional	50	$119.83	$137.84	$156.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.16 / $59.80 / $94.80	Professional	TC	$50.16	$59.80	$94.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.48 / $168.41 / $498.40	Facility		$89.48	$168.41	$498.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.58 / $105.03 / $159.72	Professional		$71.58	$105.03	$159.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.40 / $40.24 / $60.89	Professional	26	$27.40	$40.24	$60.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.41 / $64.79 / $98.93	Professional	TC	$44.41	$64.79	$98.93
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.72 / $99.94 / $149.90	Professional		$0.72	$99.94	$149.90
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.27 / $37.42 / $52.64	Professional	26	$0.27	$37.42	$52.64
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.45 / $62.52 / $87.96	Professional	TC	$0.45	$62.52	$87.96
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $97.31 / $97.31 / $97.31	Facility		$97.31	$97.31	$97.31
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.72 / $81.91 / $124.92	Professional		$0.72	$81.91	$124.92
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.27 / $31.18 / $46.77	Professional	26	$0.27	$31.18	$46.77
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.45 / $52.10 / $78.15	Professional	TC	$0.45	$52.10	$78.15
United Facility/Professional Facility Modifier Low / Median / High Price $182.03 / $182.03 / $182.03	Facility		$182.03	$182.03	$182.03
United Facility/Professional Professional Modifier Low / Median / High Price $71.62 / $89.14 / $163.69	Professional		$71.62	$89.14	$163.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.86 / $34.65 / $60.49	Professional	26	$27.86	$34.65	$60.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.76 / $54.49 / $93.38	Professional	TC	$43.76	$54.49	$93.38