Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.94 / $48.48 / $58.18	Facility	26	$38.94	$48.48	$58.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $156.83 / $262.10 / $924.00	Professional		$156.83	$262.10	$924.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.26 / $72.97 / $199.00	Professional	26	$43.26	$72.97	$199.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $64.16 / $79.23 / $402.88	Professional	52	$64.16	$79.23	$402.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $107.69 / $201.03 / $548.41	Professional	TC	$107.69	$201.03	$548.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.87 / $100.72 / $191.37	Professional		$96.87	$100.72	$191.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.15 / $57.63 / $84.85	Professional	26	$31.15	$57.63	$84.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.73 / $160.37 / $232.30	Professional		$125.73	$160.37	$232.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.10 / $48.40 / $66.09	Professional	26	$38.10	$48.40	$66.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.63 / $113.24 / $177.81	Professional	TC	$87.63	$113.24	$177.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.88 / $212.81 / $365.71	Professional		$130.88	$212.81	$365.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.35 / $59.38 / $88.04	Professional	26	$35.35	$59.38	$88.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.16 / $165.41 / $287.08	Professional	TC	$91.16	$165.41	$287.08
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.04 / $189.47 / $300.00	Professional		$2.04	$189.47	$300.00
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.59 / $55.27 / $71.06	Professional	26	$0.59	$55.27	$71.06
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.47 / $119.53 / $229.55	Professional	TC	$1.47	$119.53	$229.55
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.04 / $125.90 / $192.03	Professional		$2.04	$125.90	$192.03
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.59 / $39.47 / $59.22	Professional	26	$0.59	$39.47	$59.22
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.47 / $89.34 / $132.81	Professional	TC	$1.47	$89.34	$132.81
United Facility/Professional Professional Modifier Low / Median / High Price $119.91 / $181.08 / $324.27	Professional		$119.91	$181.08	$324.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.38 / $44.03 / $82.96	Professional	26	$37.38	$44.03	$82.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.18 / $124.72 / $253.99	Professional	TC	$82.18	$124.72	$253.99