Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $114.82	Facility	26	$95.50	$95.50	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $398.11 / $645.65	Professional		$234.42	$398.11	$645.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $95.50 / $165.96	Professional	26	$57.54	$95.50	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $302.00 / $537.03	Professional	TC	$177.83	$302.00	$537.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Professional	26	$44.67	$44.67	$44.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $275.42 / $446.68	Professional		$223.87	$275.42	$446.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $53.70 / $95.50	Professional	26	$52.48	$53.70	$95.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $218.78 / $398.11	Professional	TC	$173.78	$218.78	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $436.52 / $724.44	Professional		$234.42	$436.52	$724.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $70.79 / $109.65	Professional	26	$43.65	$70.79	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $338.84 / $645.65	Professional	TC	$177.83	$338.84	$645.65
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $5.62 / $295.12 / $426.58	Professional		$5.62	$295.12	$426.58
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.07 / $66.07 / $87.10	Professional	26	$1.07	$66.07	$87.10
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $239.88 / $338.84	Professional	TC	$134.90	$239.88	$338.84
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $5.62 / $5.62 / $338.84	Professional		$5.62	$5.62	$338.84
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.07 / $1.07 / $81.28	Professional	26	$1.07	$1.07	$81.28
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $257.04 / $269.15	Professional	TC	$257.04	$257.04	$269.15
Select Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $54.95 / $54.95	Professional	26	$53.70	$54.95	$54.95
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $169.82 / $169.82	Professional	TC	$169.82	$169.82	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $354.81 / $660.69	Professional		$218.78	$354.81	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $52.48 / $100.00	Professional	26	$43.65	$52.48	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $281.84 / $588.84	Professional	TC	$165.96	$281.84	$588.84