Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.31 / $107.31 / $132.50	Facility	26	$107.31	$107.31	$132.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $342.74 / $376.15 / $641.65	Professional		$342.74	$376.15	$641.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.56 / $107.31 / $132.50	Professional	26	$98.56	$107.31	$132.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.98 / $268.83 / $331.93	Professional	TC	$220.98	$268.83	$331.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $298.60 / $421.34 / $637.55	Professional		$298.60	$421.34	$637.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.54 / $124.04 / $178.51	Professional	26	$102.54	$124.04	$178.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.89 / $303.36 / $459.04	Professional	TC	$190.89	$303.36	$459.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $265.11 / $325.51 / $575.74	Professional		$265.11	$325.51	$575.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.61 / $115.87 / $164.25	Professional	26	$89.61	$115.87	$164.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $175.50 / $215.27 / $411.49	Professional	TC	$175.50	$215.27	$411.49
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $7.20 / $353.47 / $577.16	Professional		$7.20	$353.47	$577.16
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.84 / $120.26 / $183.00	Professional	26	$1.84	$120.26	$183.00
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $5.91 / $259.08 / $405.41	Professional	TC	$5.91	$259.08	$405.41
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $5.40 / $329.05 / $494.72	Professional		$5.40	$329.05	$494.72
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.38 / $104.57 / $156.86	Professional	26	$1.38	$104.57	$156.86
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.01 / $225.23 / $353.31	Professional	TC	$4.01	$225.23	$353.31
United Facility/Professional Professional Modifier Low / Median / High Price $320.70 / $395.20 / $612.59	Professional		$320.70	$395.20	$612.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.81 / $142.28 / $194.05	Professional	26	$107.81	$142.28	$194.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $219.64 / $265.20 / $438.92	Professional	TC	$219.64	$265.20	$438.92