Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $209.13 / $1,181.25 / $1,352.24	Facility		$209.13	$1,181.25	$1,352.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.67 / $38.86 / $46.64	Facility	26	$36.67	$38.86	$46.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.38 / $140.72 / $636.00	Professional		$111.38	$140.72	$636.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $50.39 / $190.00	Professional	26	$34.67	$50.39	$190.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.67 / $99.56 / $454.00	Professional	TC	$79.67	$99.56	$454.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.29 / $89.29 / $141.76	Professional		$89.29	$89.29	$141.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.34 / $36.45 / $72.18	Professional	26	$29.34	$36.45	$72.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $91.36 / $91.36 / $91.36	Professional	TC	$91.36	$91.36	$91.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $116.23 / $145.29 / $437.00	Facility		$116.23	$145.29	$437.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.07 / $123.55 / $182.62	Professional		$112.07	$123.55	$182.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.19 / $39.90 / $56.53	Professional	26	$36.19	$39.90	$56.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.88 / $84.33 / $124.06	Professional	TC	$75.88	$84.33	$124.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.56 / $203.39 / $670.85	Facility		$78.56	$203.39	$670.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.97 / $152.01 / $221.23	Professional		$99.97	$152.01	$221.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.33 / $49.78 / $71.73	Professional	26	$32.33	$49.78	$71.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.34 / $101.90 / $149.88	Professional	TC	$64.34	$101.90	$149.88
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.93 / $136.78 / $200.00	Professional		$0.93	$136.78	$200.00
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.43 / $44.03 / $62.80	Professional	26	$0.43	$44.03	$62.80
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.50 / $92.15 / $134.38	Professional	TC	$0.50	$92.15	$134.38
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 $0.93 / $111.62 / $170.97	Professional		$0.93	$111.62	$170.97
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.43 / $37.20 / $55.80	Professional	26	$0.43	$37.20	$55.80
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.50 / $76.79 / $115.19	Professional	TC	$0.50	$76.79	$115.19
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 $99.18 / $125.23 / $211.63	Professional		$99.18	$125.23	$211.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.99 / $41.86 / $76.19	Professional	26	$28.99	$41.86	$76.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.19 / $83.37 / $149.77	Professional	TC	$70.19	$83.37	$149.77