Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $117.49 / $141.25	Facility	26	$117.49	$117.49	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $478.63 / $1,047.13	Professional		$346.74	$478.63	$1,047.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $120.23 / $323.59	Professional	26	$72.44	$120.23	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $354.81 / $812.83	Professional	TC	$263.03	$354.81	$812.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $245.47 / $489.78	Professional		$223.87	$245.47	$489.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $52.48 / $61.66	Professional	26	$51.29	$52.48	$61.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $398.11 / $616.60	Professional		$331.13	$398.11	$616.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $75.86 / $117.49	Professional	26	$66.07	$75.86	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $323.59 / $537.03	Professional	TC	$263.03	$323.59	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $645.65 / $1,258.93	Professional		$338.84	$645.65	$1,258.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $97.72 / $151.36	Professional	26	$53.70	$97.72	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $512.86 / $1,122.02	Professional	TC	$269.15	$512.86	$1,122.02
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $6.31 / $426.58 / $602.56	Professional		$6.31	$426.58	$602.56
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.35 / $81.28 / $112.20	Professional	26	$1.35	$81.28	$112.20
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $338.84 / $489.78	Professional	TC	$181.97	$338.84	$489.78
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $6.31 / $6.31 / $489.78	Professional		$6.31	$6.31	$489.78
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.35 / $1.35 / $100.00	Professional	26	$1.35	$1.35	$100.00
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $302.00 / $389.05	Professional	TC	$302.00	$302.00	$389.05
Select Health Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $323.59	Professional		$323.59	$323.59	$323.59
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $67.61	Professional	26	$67.61	$67.61	$67.61
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $257.04 / $257.04	Professional	TC	$257.04	$257.04	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $512.86 / $1,122.02	Professional		$323.59	$512.86	$1,122.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $74.13 / $134.90	Professional	26	$60.26	$74.13	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $436.52 / $1,023.29	Professional	TC	$251.19	$436.52	$1,023.29