Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.57 / $877.76 / $1,078.18	Facility		$200.57	$877.76	$1,078.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.37 / $24.15 / $291.69	Facility	26	$22.37	$24.15	$291.69
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $95.86 / $218.71 / $893.94	Facility	TC	$95.86	$218.71	$893.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.63 / $130.50 / $559.67	Professional		$23.63	$130.50	$559.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.77 / $24.15 / $106.00	Professional	26	$19.77	$24.15	$106.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.37 / $102.68 / $243.09	Professional	TC	$91.37	$102.68	$243.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.55 / $97.12 / $173.66	Professional		$76.55	$97.12	$173.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.92 / $29.22 / $36.47	Professional	26	$15.92	$29.22	$36.47
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $115.01 / $115.01 / $115.01	Professional	TC	$115.01	$115.01	$115.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.18 / $124.24 / $171.40	Professional		$114.18	$124.24	$171.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.20 / $21.80 / $27.58	Professional	26	$19.20	$21.80	$27.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $92.19 / $102.44 / $140.02	Professional	TC	$92.19	$102.44	$140.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.44 / $203.39 / $670.85	Facility		$120.44	$203.39	$670.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.25 / $168.38 / $244.31	Professional		$113.25	$168.38	$244.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.41 / $28.81 / $39.22	Professional	26	$20.41	$28.81	$39.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.51 / $139.85 / $210.03	Professional	TC	$93.51	$139.85	$210.03
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.34 / $139.27 / $203.11	Professional		$2.34	$139.27	$203.11
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.40 / $23.51 / $34.11	Professional	26	$0.40	$23.51	$34.11
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.68 / $110.22 / $161.81	Professional	TC	$1.68	$110.22	$161.81
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 $2.34 / $114.25 / $174.09	Professional		$2.34	$114.25	$174.09
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.45 / $20.21 / $30.32	Professional	26	$0.45	$20.21	$30.32
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.89 / $95.84 / $143.76	Professional	TC	$1.89	$95.84	$143.76
United Facility/Professional Professional Modifier Low / Median / High Price $113.19 / $167.57 / $253.67	Professional		$113.19	$167.57	$253.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.47 / $28.58 / $48.03	Professional	26	$20.47	$28.58	$48.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.92 / $147.30 / $232.02	Professional	TC	$89.92	$147.30	$232.02