Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $479.29 / $1,061.66 / $1,185.24	Facility		$479.29	$1,061.66	$1,185.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.23 / $26.16 / $29.08	Facility	26	$24.23	$26.16	$29.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.67 / $142.72 / $623.00	Professional		$117.67	$142.72	$623.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.44 / $24.23 / $125.15	Professional	26	$18.44	$24.23	$125.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.50 / $109.01 / $206.11	Professional	TC	$99.50	$109.01	$206.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.80 / $105.11 / $134.16	Professional		$85.80	$105.11	$134.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.18 / $17.62 / $32.63	Professional	26	$17.18	$17.62	$32.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.13 / $149.16 / $167.15	Professional		$116.13	$149.16	$167.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.75 / $23.53 / $27.11	Professional	26	$19.75	$23.53	$27.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $96.30 / $125.63 / $140.03	Professional	TC	$96.30	$125.63	$140.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $121.17 / $203.39 / $670.85	Facility		$121.17	$203.39	$670.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.38 / $203.11 / $303.39	Professional		$133.38	$203.11	$303.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.30 / $26.33 / $42.10	Professional	26	$18.30	$26.33	$42.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.39 / $173.09 / $258.50	Professional	TC	$115.39	$173.09	$258.50
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.70 / $150.02 / $225.63	Professional		$2.70	$150.02	$225.63
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.40 / $26.52 / $37.31	Professional	26	$0.40	$26.52	$37.31
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.00 / $122.84 / $180.34	Professional	TC	$2.00	$122.84	$180.34
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 $2.70 / $128.93 / $193.40	Professional		$2.70	$128.93	$193.40
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.45 / $22.10 / $33.15	Professional	26	$0.45	$22.10	$33.15
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.25 / $106.82 / $160.22	Professional	TC	$2.25	$106.82	$160.22
United Facility/Professional Professional Modifier Low / Median / High Price $139.49 / $207.30 / $309.52	Professional		$139.49	$207.30	$309.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.89 / $27.19 / $46.23	Professional	26	$19.89	$27.19	$46.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.15 / $181.74 / $276.67	Professional	TC	$117.15	$181.74	$276.67