Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.64 / $65.64 / $81.04	Facility		$65.64	$65.64	$81.04
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.04 / $38.04 / $46.97	Facility	26	$38.04	$38.04	$46.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.20 / $88.80 / $253.00	Professional		$39.20	$88.80	$253.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.40 / $55.15 / $89.47	Professional	26	$34.40	$55.15	$89.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.34 / $41.62 / $157.97	Professional	TC	$26.34	$41.62	$157.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.51 / $85.48 / $206.69	Professional		$58.51	$85.48	$206.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.10 / $48.56 / $79.37	Professional	26	$33.10	$48.56	$79.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.94 / $36.53 / $127.32	Professional	TC	$24.94	$36.53	$127.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.90 / $27.90 / $27.90	Facility		$27.90	$27.90	$27.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.81 / $120.55 / $306.48	Professional		$71.81	$120.55	$306.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $63.55 / $115.76	Professional	26	$38.90	$63.55	$115.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.12 / $50.67 / $189.70	Professional	TC	$31.12	$50.67	$189.70
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.22 / $85.88 / $203.65	Professional		$3.22	$85.88	$203.65
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.47 / $45.86 / $73.72	Professional	26	$1.47	$45.86	$73.72
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.00 / $36.71 / $100.84	Professional	TC	$2.00	$36.71	$100.84
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $172.92 / $172.92 / $172.92	Facility		$172.92	$172.92	$172.92
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.76 / $61.75 / $99.09	Professional		$2.76	$61.75	$99.09
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.26 / $36.69 / $55.04	Professional	26	$1.26	$36.69	$55.04
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.50 / $44.06 / $45.74	Professional	TC	$1.50	$44.06	$45.74
United Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $1,427.00 / $1,998.00	Facility		$200.00	$1,427.00	$1,998.00
United Facility/Professional Professional Modifier Low / Median / High Price $64.72 / $120.96 / $273.94	Professional		$64.72	$120.96	$273.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.94 / $60.05 / $98.54	Professional	26	$36.94	$60.05	$98.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.12 / $51.65 / $175.40	Professional	TC	$27.12	$51.65	$175.40