Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $676.08	Facility	26	$77.62	$77.62	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $281.84 / $912.01	Professional		$186.21	$281.84	$912.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $93.33 / $302.00	Professional	26	$61.66	$93.33	$302.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $190.55 / $537.03	Professional	TC	$123.03	$190.55	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $144.54 / $229.09	Professional		$123.03	$144.54	$229.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $52.48 / $97.72	Professional	26	$48.98	$52.48	$97.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $72.44 / $87.10	Professional	TC	$72.44	$72.44	$87.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $213.80 / $323.59	Professional		$181.97	$213.80	$323.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $61.66 / $109.65	Professional	26	$60.26	$61.66	$109.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $147.91 / $213.80	Professional	TC	$120.23	$147.91	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $295.12 / $457.09	Professional		$181.97	$295.12	$457.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $81.28 / $117.49	Professional	26	$50.12	$81.28	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $199.53 / $354.81	Professional	TC	$123.03	$199.53	$354.81
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.40 / $239.88 / $309.03	Professional		$2.40	$239.88	$309.03
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.72 / $75.86 / $100.00	Professional	26	$0.72	$75.86	$100.00
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $154.88 / $208.93	Professional	TC	$91.20	$154.88	$208.93
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.40 / $2.40 / $275.42	Professional		$2.40	$2.40	$275.42
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.72 / $0.72 / $95.50	Professional	26	$0.72	$0.72	$95.50
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $151.36 / $181.97	Professional	TC	$151.36	$151.36	$181.97
Select Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $63.10 / $63.10	Professional	26	$63.10	$63.10	$63.10
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $120.23 / $120.23	Professional	TC	$117.49	$120.23	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $245.47 / $380.19	Professional		$173.78	$245.47	$380.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $60.26 / $114.82	Professional	26	$50.12	$60.26	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $158.49 / $295.12	Professional	TC	$109.65	$158.49	$295.12