Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $91.20 / $109.65	Facility	26	$91.20	$91.20	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $316.23 / $831.76	Professional		$223.87	$316.23	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $85.11 / $199.53	Professional	26	$61.66	$85.11	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $213.80 / $371.54	Professional	TC	$147.91	$213.80	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $169.82 / $218.78	Professional		$144.54	$169.82	$218.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $58.88 / $67.61	Professional	26	$56.23	$58.88	$67.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	TC	$97.72	$97.72	$97.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $251.19 / $389.05	Professional		$218.78	$251.19	$389.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $72.44 / $128.82	Professional	26	$64.57	$72.44	$128.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $181.97 / $269.15	Professional	TC	$147.91	$181.97	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $346.74 / $549.54	Professional		$218.78	$346.74	$549.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $89.13 / $141.25	Professional	26	$57.54	$89.13	$141.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $239.88 / $426.58	Professional	TC	$151.36	$239.88	$426.58
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.95 / $288.40 / $371.54	Professional		$2.95	$288.40	$371.54
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.78 / $87.10 / $117.49	Professional	26	$0.78	$87.10	$117.49
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $190.55 / $257.04	Professional	TC	$91.20	$190.55	$257.04
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.95 / $2.95 / $331.13	Professional		$2.95	$2.95	$331.13
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.78 / $0.78 / $109.65	Professional	26	$0.78	$0.78	$109.65
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $151.36 / $218.78	Professional	TC	$151.36	$151.36	$218.78
Select Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Professional		$218.78	$218.78	$218.78
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $74.13 / $74.13	Professional	26	$72.44	$74.13	$74.13
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	TC	$144.54	$144.54	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $295.12 / $457.09	Professional		$208.93	$295.12	$457.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $70.79 / $131.83	Professional	26	$52.48	$70.79	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $194.98 / $371.54	Professional	TC	$131.83	$194.98	$371.54