Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $396.72 / $1,364.24 / $1,615.51	Facility		$396.72	$1,364.24	$1,615.51
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.22 / $35.22 / $42.28	Facility	26	$35.22	$35.22	$42.28
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $174.80 / $403.79 / $1,036.33	Facility	TC	$174.80	$403.79	$1,036.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.06 / $214.39 / $958.00	Professional		$175.06	$214.39	$958.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.50 / $35.70 / $170.10	Professional	26	$30.50	$35.70	$170.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.60 / $162.49 / $427.06	Professional	TC	$144.60	$162.49	$427.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $119.61 / $142.78 / $174.66	Professional		$119.61	$142.78	$174.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.64 / $45.58 / $60.88	Professional	26	$24.64	$45.58	$60.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.47 / $195.89 / $270.08	Professional		$172.47	$195.89	$270.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.50 / $34.26 / $41.96	Professional	26	$30.50	$34.26	$41.96
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $140.33 / $161.62 / $223.17	Professional	TC	$140.33	$161.62	$223.17
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 $170.65 / $266.07 / $385.50	Professional		$170.65	$266.07	$385.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.34 / $44.54 / $61.60	Professional	26	$31.34	$44.54	$61.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.22 / $222.64 / $327.12	Professional	TC	$147.22	$222.64	$327.12
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.24 / $211.26 / $321.48	Professional		$3.24	$211.26	$321.48
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.80 / $37.15 / $53.59	Professional	26	$0.80	$37.15	$53.59
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.08 / $174.75 / $256.55	Professional	TC	$2.08	$174.75	$256.55
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 $3.24 / $178.47 / $275.55	Professional		$3.24	$178.47	$275.55
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.90 / $31.74 / $47.61	Professional	26	$0.90	$31.74	$47.61
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.34 / $151.96 / $227.94	Professional	TC	$2.34	$151.96	$227.94
United Facility/Professional Professional Modifier Low / Median / High Price $168.07 / $257.33 / $398.84	Professional		$168.07	$257.33	$398.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.37 / $41.69 / $66.64	Professional	26	$31.37	$41.69	$66.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $149.76 / $224.58 / $347.14	Professional	TC	$149.76	$224.58	$347.14