Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Facility	26	$107.15	$107.15	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $380.19 / $831.76	Professional		$338.84	$380.19	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $109.65 / $562.34	Professional	26	$97.72	$109.65	$562.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $269.15 / $380.19	Professional	TC	$218.78	$269.15	$380.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $512.86 / $645.65	Professional		$302.00	$512.86	$645.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $141.25 / $213.80	Professional	26	$107.15	$141.25	$213.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $363.08 / $457.09	Professional	TC	$190.55	$363.08	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $331.13 / $549.54	Professional		$263.03	$331.13	$549.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $114.82 / $173.78	Professional	26	$91.20	$114.82	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $218.78 / $407.38	Professional	TC	$173.78	$218.78	$407.38
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $6.31 / $331.13 / $562.34	Professional		$6.31	$331.13	$562.34
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.62 / $104.71 / $177.83	Professional	26	$1.62	$104.71	$177.83
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $269.15 / $398.11	Professional	TC	$169.82	$269.15	$398.11
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $5.37 / $5.37 / $489.78	Professional		$5.37	$5.37	$489.78
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.38 / $1.38 / $158.49	Professional	26	$1.38	$1.38	$158.49
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $338.84 / $354.81	Professional	TC	$338.84	$338.84	$354.81
Select Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Professional		$331.13	$331.13	$331.13
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $104.71 / $104.71	Professional	26	$100.00	$104.71	$104.71
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $223.87 / $229.09	Professional	TC	$223.87	$223.87	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $389.05 / $616.60	Professional		$302.00	$389.05	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $141.25 / $190.55	Professional	26	$107.15	$141.25	$190.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $263.03 / $426.58	Professional	TC	$208.93	$263.03	$426.58