Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $707.95	Facility	26	$72.44	$72.44	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $275.42 / $602.56	Professional		$173.78	$275.42	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $77.62 / $281.84	Professional	26	$54.95	$77.62	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $181.97 / $331.13	Professional	TC	$114.82	$181.97	$331.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $131.83 / $173.78	Professional		$114.82	$131.83	$173.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $46.77 / $93.33	Professional	26	$44.67	$46.77	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $199.53 / $309.03	Professional		$169.82	$199.53	$309.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $57.54 / $102.33	Professional	26	$56.23	$57.54	$102.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $131.83 / $223.87	Professional	TC	$114.82	$131.83	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $288.40 / $467.74	Professional		$165.96	$288.40	$467.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $75.86 / $114.82	Professional	26	$45.71	$75.86	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $194.98 / $380.19	Professional	TC	$117.49	$194.98	$380.19
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.82 / $208.93 / $288.40	Professional		$2.82	$208.93	$288.40
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.68 / $69.18 / $93.33	Professional	26	$0.68	$69.18	$93.33
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $147.91 / $190.55	Professional	TC	$85.11	$147.91	$190.55
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.82 / $2.82 / $257.04	Professional		$2.82	$2.82	$257.04
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.68 / $0.68 / $87.10	Professional	26	$0.68	$0.68	$87.10
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $151.36 / $173.78	Professional	TC	$151.36	$151.36	$173.78
Select Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $173.78 / $173.78	Professional		$169.82	$173.78	$173.78
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $57.54 / $57.54	Professional	26	$57.54	$57.54	$57.54
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $114.82 / $114.82	Professional	TC	$112.20	$114.82	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $239.88 / $407.38	Professional		$165.96	$239.88	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $54.95 / $107.15	Professional	26	$45.71	$54.95	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $151.36 / $338.84	Professional	TC	$104.71	$151.36	$338.84