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 / $446.68 / $977.24	Professional		$234.42	$446.68	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $117.49 / $309.03	Professional	26	$56.23	$117.49	$309.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $302.00 / $562.34	Professional	TC	$169.82	$302.00	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $169.82 / $323.59	Professional		$141.25	$169.82	$323.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $43.65 / $46.77	Professional	26	$42.66	$43.65	$46.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $257.04 / $407.38	Professional		$213.80	$257.04	$407.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $56.23 / $95.50	Professional	26	$53.70	$56.23	$95.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $194.98 / $346.74	Professional	TC	$162.18	$194.98	$346.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $426.58 / $724.44	Professional		$218.78	$426.58	$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 $165.96 / $323.59 / $645.65	Professional	TC	$165.96	$323.59	$645.65
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.90 / $281.84 / $380.19	Professional		$4.90	$281.84	$380.19
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.89 / $66.07 / $87.10	Professional	26	$0.89	$66.07	$87.10
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $208.93 / $302.00	Professional	TC	$120.23	$208.93	$302.00
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.90 / $4.90 / $323.59	Professional		$4.90	$4.90	$323.59
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.89 / $0.89 / $81.28	Professional	26	$0.89	$0.89	$81.28
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $204.17 / $239.88	Professional	TC	$204.17	$204.17	$239.88
Select Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Professional		$213.80	$213.80	$213.80
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $54.95 / $54.95	Professional	26	$54.95	$54.95	$54.95
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $158.49 / $158.49	Professional	TC	$158.49	$158.49	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $346.74 / $660.69	Professional		$213.80	$346.74	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $52.48 / $100.00	Professional	26	$42.66	$52.48	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $281.84 / $588.84	Professional	TC	$154.88	$281.84	$588.84