Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $274.05 / $1,182.85 / $1,660.66	Facility		$274.05	$1,182.85	$1,660.66
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.75 / $42.92 / $47.70	Facility	26	$39.75	$42.92	$47.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $231.12 / $455.84 / $947.76	Facility	TC	$231.12	$455.84	$947.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.31 / $253.75 / $974.00	Professional		$189.31	$253.75	$974.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $36.68 / $190.00	Professional	26	$26.96	$36.68	$190.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $190.99 / $375.25	Professional	TC	$162.34	$190.99	$375.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $174.82 / $182.81 / $347.34	Professional		$174.82	$182.81	$347.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.22 / $28.82 / $69.73	Professional	26	$28.22	$28.82	$69.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $191.20 / $252.30 / $269.18	Professional		$191.20	$252.30	$269.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.05 / $38.76 / $39.88	Professional	26	$29.05	$38.76	$39.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.15 / $213.54 / $227.74	Professional	TC	$162.15	$213.54	$227.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $254.54 / $462.32 / $1,417.79	Facility		$254.54	$462.32	$1,417.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.58 / $339.99 / $474.32	Professional		$216.58	$339.99	$474.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.53 / $40.78 / $68.79	Professional	26	$27.53	$40.78	$68.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.47 / $288.04 / $429.00	Professional	TC	$181.47	$288.04	$429.00
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.60 / $260.77 / $400.25	Professional		$3.60	$260.77	$400.25
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.80 / $41.81 / $61.39	Professional	26	$0.80	$41.81	$61.39
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.40 / $210.76 / $338.88	Professional	TC	$2.40	$210.76	$338.88
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $267.14 / $267.14 / $267.14	Facility		$267.14	$267.14	$267.14
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.60 / $228.51 / $355.61	Professional		$3.60	$228.51	$355.61
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.90 / $36.36 / $54.54	Professional	26	$0.90	$36.36	$54.54
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.70 / $200.72 / $301.08	Professional	TC	$2.70	$200.72	$301.08
United Facility/Professional Professional Modifier Low / Median / High Price $229.44 / $322.64 / $503.31	Professional		$229.44	$322.64	$503.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.74 / $40.67 / $73.56	Professional	26	$28.74	$40.67	$73.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.98 / $300.81 / $453.59	Professional	TC	$199.98	$300.81	$453.59