Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.48 / $495.26 / $1,728.30	Facility		$110.48	$495.26	$1,728.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.44 / $35.51 / $42.61	Facility	26	$33.44	$35.51	$42.61
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $82.70 / $202.37 / $655.35	Facility	TC	$82.70	$202.37	$655.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.87 / $137.58 / $639.00	Professional		$103.87	$137.58	$639.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.67 / $39.85 / $193.49	Professional	26	$31.67	$39.85	$193.49
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $49.17 / $55.72 / $328.05	Professional	52	$49.17	$55.72	$328.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.40 / $99.56 / $201.04	Professional	TC	$73.40	$99.56	$201.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.34 / $83.34 / $185.47	Professional		$83.34	$83.34	$185.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.75 / $50.83 / $72.87	Professional	26	$26.75	$50.83	$72.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $108.50 / $135.63 / $437.00	Facility		$108.50	$135.63	$437.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.82 / $114.45 / $169.74	Professional		$103.82	$114.45	$169.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.02 / $36.40 / $51.46	Professional	26	$33.02	$36.40	$51.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.80 / $78.70 / $119.36	Professional	TC	$70.80	$78.70	$119.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.56 / $203.39 / $670.85	Facility		$73.56	$203.39	$670.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.60 / $142.37 / $205.02	Professional		$96.60	$142.37	$205.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $45.57 / $65.89	Professional	26	$29.51	$45.57	$65.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.34 / $97.05 / $143.75	Professional	TC	$64.34	$97.05	$143.75
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.90 / $127.57 / $191.35	Professional		$0.90	$127.57	$191.35
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.40 / $40.22 / $57.15	Professional	26	$0.40	$40.22	$57.15
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.50 / $86.93 / $126.77	Professional	TC	$0.50	$86.93	$126.77
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 $0.90 / $104.18 / $159.44	Professional		$0.90	$104.18	$159.44
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.40 / $33.85 / $50.78	Professional	26	$0.40	$33.85	$50.78
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.50 / $72.44 / $108.66	Professional	TC	$0.50	$72.44	$108.66
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 $95.49 / $115.13 / $200.98	Professional		$95.49	$115.13	$200.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.50 / $37.53 / $59.21	Professional	26	$29.50	$37.53	$59.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.06 / $77.59 / $142.50	Professional	TC	$69.06	$77.59	$142.50