Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.04 / $105.04 / $129.69	Facility	26	$105.04	$105.04	$129.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.81 / $407.09 / $1,660.00	Professional		$312.81	$407.09	$1,660.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.56 / $110.37 / $525.53	Professional	26	$101.56	$110.37	$525.53
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $186.01 / $297.13 / $326.69	Professional	52	$186.01	$297.13	$326.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $198.49 / $273.58 / $446.69	Professional	TC	$198.49	$273.58	$446.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $297.64 / $424.40 / $642.19	Professional		$297.64	$424.40	$642.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.07 / $121.62 / $175.03	Professional	26	$104.07	$121.62	$175.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $191.26 / $308.73 / $467.15	Professional	TC	$191.26	$308.73	$467.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.77 / $329.52 / $579.53	Professional		$263.77	$329.52	$579.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.97 / $114.29 / $160.78	Professional	26	$85.97	$114.29	$160.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.80 / $219.99 / $418.75	Professional	TC	$177.80	$219.99	$418.75
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $7.60 / $351.34 / $588.09	Professional		$7.60	$351.34	$588.09
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.76 / $118.59 / $180.46	Professional	26	$1.76	$118.59	$180.46
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $6.44 / $267.86 / $419.26	Professional	TC	$6.44	$267.86	$419.26
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $5.70 / $327.63 / $504.08	Professional		$5.70	$327.63	$504.08
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.32 / $103.12 / $154.68	Professional	26	$1.32	$103.12	$154.68
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.38 / $232.92 / $365.40	Professional	TC	$4.38	$232.92	$365.40
United Facility/Professional Professional Modifier Low / Median / High Price $322.20 / $400.00 / $610.92	Professional		$322.20	$400.00	$610.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.64 / $129.79 / $189.11	Professional	26	$102.64	$129.79	$189.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $220.08 / $274.72 / $439.75	Professional	TC	$220.08	$274.72	$439.75