Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $117.49 / $141.25	Facility	26	$117.49	$117.49	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $467.74 / $1,096.48	Professional		$281.84	$467.74	$1,096.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $117.49 / $199.53	Professional	26	$70.79	$117.49	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $338.84 / $602.56	Professional	TC	$204.17	$338.84	$602.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $208.93 / $323.59	Professional		$173.78	$208.93	$323.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $56.23 / $56.23	Professional	26	$56.23	$56.23	$56.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $288.40 / $478.63	Professional		$269.15	$288.40	$478.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $66.07 / $117.49	Professional	26	$64.57	$66.07	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $218.78 / $354.81	Professional	TC	$199.53	$218.78	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $436.52 / $676.08	Professional		$269.15	$436.52	$676.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $85.11 / $131.83	Professional	26	$53.70	$85.11	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $346.74 / $575.44	Professional	TC	$204.17	$346.74	$575.44
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.90 / $338.84 / $436.52	Professional		$4.90	$338.84	$436.52
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.89 / $79.43 / $107.15	Professional	26	$0.89	$79.43	$107.15
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $251.19 / $331.13	Professional	TC	$123.03	$251.19	$331.13
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.90 / $4.90 / $389.05	Professional		$4.90	$4.90	$389.05
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.89 / $0.89 / $100.00	Professional	26	$0.89	$0.89	$100.00
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $204.17 / $288.40	Professional	TC	$204.17	$204.17	$288.40
Select Health Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Professional		$257.04	$257.04	$257.04
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $66.07 / $66.07	Professional	26	$66.07	$66.07	$66.07
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $190.55 / $190.55	Professional	TC	$190.55	$190.55	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $371.54 / $616.60	Professional		$257.04	$371.54	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $64.57 / $123.03	Professional	26	$53.70	$64.57	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $281.84 / $524.81	Professional	TC	$186.21	$281.84	$524.81