Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $284.55 / $2,216.92 / $3,995.73	Facility		$284.55	$2,216.92	$3,995.73
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.11 / $85.33 / $128.97	Facility	26	$71.11	$85.33	$128.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.46 / $254.66 / $927.00	Professional		$180.46	$254.66	$927.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.20 / $76.63 / $274.00	Professional	26	$64.20	$76.63	$274.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $117.02 / $175.12 / $665.00	Professional	TC	$117.02	$175.12	$665.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.06 / $150.06 / $281.37	Professional		$150.06	$150.06	$281.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.11 / $55.37 / $123.11	Professional	26	$52.11	$55.37	$123.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $104.08 / $104.08 / $104.08	Professional	TC	$104.08	$104.08	$104.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $197.09 / $313.20 / $440.46	Professional		$197.09	$313.20	$440.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.58 / $89.30 / $131.72	Professional	26	$67.58	$89.30	$131.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $131.75 / $223.90 / $314.87	Professional	TC	$131.75	$223.90	$314.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.93 / $275.64 / $393.52	Professional		$183.93	$275.64	$393.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.79 / $85.91 / $128.00	Professional	26	$62.79	$85.91	$128.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.36 / $193.32 / $271.56	Professional	TC	$126.36	$193.32	$271.56
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.65 / $225.89 / $343.75	Professional		$3.65	$225.89	$343.75
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.25 / $77.29 / $117.62	Professional	26	$1.25	$77.29	$117.62
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.40 / $148.60 / $226.14	Professional	TC	$2.40	$148.60	$226.14
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $605.97 / $605.97 / $605.97	Facility		$605.97	$605.97	$605.97
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.65 / $187.58 / $294.64	Professional		$3.65	$187.58	$294.64
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.25 / $67.20 / $100.82	Professional	26	$1.25	$67.20	$100.82
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.40 / $129.22 / $193.83	Professional	TC	$2.40	$129.22	$193.83
United Facility/Professional Professional Modifier Low / Median / High Price $178.24 / $281.95 / $445.20	Professional		$178.24	$281.95	$445.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.80 / $87.57 / $141.44	Professional	26	$64.80	$87.57	$141.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.52 / $199.60 / $310.20	Professional	TC	$128.52	$199.60	$310.20