Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.93 / $73.00 / $141.22	Facility	26	$66.93	$73.00	$141.22
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $62.29 / $95.46 / $414.15	Facility	53	$62.29	$95.46	$414.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.95 / $475.00 / $1,453.26	Professional		$210.95	$475.00	$1,453.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.59 / $140.00 / $456.00	Professional	26	$70.59	$140.00	$456.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $120.07 / $187.50 / $644.72	Professional	52	$120.07	$187.50	$644.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.48 / $335.00 / $565.00	Professional	TC	$192.48	$335.00	$565.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $148.99 / $189.44 / $293.33	Professional		$148.99	$189.44	$293.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.54 / $101.73 / $145.84	Professional	26	$53.54	$101.73	$145.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.62 / $254.57 / $391.43	Professional		$194.62	$254.57	$391.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.91 / $66.34 / $111.33	Professional	26	$64.91	$66.34	$111.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.27 / $167.77 / $318.85	Professional	TC	$128.27	$167.77	$318.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.87 / $385.96 / $709.76	Professional		$200.87	$385.96	$709.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.42 / $90.53 / $133.85	Professional	26	$58.42	$90.53	$133.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $133.16 / $252.10 / $634.00	Professional	TC	$133.16	$252.10	$634.00
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.95 / $280.77 / $517.64	Professional		$4.95	$280.77	$517.64
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.90 / $87.58 / $117.90	Professional	26	$0.90	$87.58	$117.90
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.05 / $186.48 / $425.00	Professional	TC	$4.05	$186.48	$425.00
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.95 / $192.98 / $292.47	Professional		$4.95	$192.98	$292.47
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.90 / $67.37 / $101.06	Professional	26	$0.90	$67.37	$101.06
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.05 / $191.42 / $199.80	Professional	TC	$4.05	$191.42	$199.80
United Facility/Professional Professional Modifier Low / Median / High Price $175.21 / $241.67 / $631.26	Professional		$175.21	$241.67	$631.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.15 / $65.31 / $139.84	Professional	26	$53.15	$65.31	$139.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.90 / $166.80 / $579.03	Professional	TC	$127.90	$166.80	$579.03