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 / $87.10	Facility	26	$72.44	$72.44	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $281.84 / $616.60	Professional		$208.93	$281.84	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $72.44 / $169.82	Professional	26	$54.95	$72.44	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $218.78 / $380.19	Professional	TC	$154.88	$218.78	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $208.93	Professional		$169.82	$169.82	$208.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $45.71 / $47.86	Professional	26	$44.67	$45.71	$47.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $251.19 / $371.54	Professional		$208.93	$251.19	$371.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $63.10 / $102.33	Professional	26	$56.23	$63.10	$102.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $186.21 / $302.00	Professional	TC	$151.36	$186.21	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $354.81 / $588.84	Professional		$213.80	$354.81	$588.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $83.18 / $114.82	Professional	26	$45.71	$83.18	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $275.42 / $446.68	Professional	TC	$158.49	$275.42	$446.68
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.95 / $269.15 / $363.08	Professional		$2.95	$269.15	$363.08
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.78 / $69.18 / $95.50	Professional	26	$0.78	$69.18	$95.50
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $194.98 / $275.42	Professional	TC	$91.20	$194.98	$275.42
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.95 / $2.95 / $316.23	Professional		$2.95	$2.95	$316.23
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.78 / $0.78 / $87.10	Professional	26	$0.78	$0.78	$87.10
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $151.36 / $229.09	Professional	TC	$151.36	$151.36	$229.09
Select Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $208.93 / $208.93	Professional		$204.17	$208.93	$208.93
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 $147.91 / $151.36 / $151.36	Professional	TC	$147.91	$151.36	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $302.00 / $489.78	Professional		$208.93	$302.00	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $63.10 / $107.15	Professional	26	$52.48	$63.10	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $218.78 / $407.38	Professional	TC	$147.91	$218.78	$407.38