Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.44 / $228.53 / $534.76	Facility		$190.44	$228.53	$534.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.46 / $43.69 / $48.55	Facility	26	$40.46	$43.69	$48.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.37 / $204.21 / $933.00	Professional		$168.37	$204.21	$933.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.82 / $37.10 / $72.37	Professional	26	$30.82	$37.10	$72.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $130.53 / $162.49 / $265.99	Professional	TC	$130.53	$162.49	$265.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.61 / $138.61 / $169.73	Professional		$138.61	$138.61	$169.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $72.12 / $72.12 / $72.12	Professional	26	$72.12	$72.12	$72.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $161.27 / $188.62 / $235.60	Professional		$161.27	$188.62	$235.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.02 / $39.10 / $40.06	Professional	26	$27.02	$39.10	$40.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $134.25 / $149.51 / $191.69	Professional	TC	$134.25	$149.51	$191.69
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 $172.90 / $256.81 / $363.60	Professional		$172.90	$256.81	$363.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.21 / $43.45 / $70.73	Professional	26	$30.21	$43.45	$70.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $137.63 / $211.32 / $304.30	Professional	TC	$137.63	$211.32	$304.30
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.96 / $215.68 / $314.52	Professional		$3.96	$215.68	$314.52
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.80 / $40.47 / $62.13	Professional	26	$0.80	$40.47	$62.13
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.72 / $171.52 / $241.31	Professional	TC	$2.72	$171.52	$241.31
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 $3.96 / $173.27 / $269.60	Professional		$3.96	$173.27	$269.60
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.90 / $36.79 / $55.20	Professional	26	$0.90	$36.79	$55.20
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $3.06 / $142.93 / $214.40	Professional	TC	$3.06	$142.93	$214.40
United Facility/Professional Facility Modifier Low / Median / High Price $190.44 / $190.44 / $190.44	Facility		$190.44	$190.44	$190.44
United Facility/Professional Professional Modifier Low / Median / High Price $174.69 / $243.92 / $380.82	Professional		$174.69	$243.92	$380.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.29 / $44.80 / $75.67	Professional	26	$32.29	$44.80	$75.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.60 / $210.00 / $318.95	Professional	TC	$138.60	$210.00	$318.95