Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.00 / $80.79 / $169.46	Facility	26	$73.00	$80.79	$169.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $344.36 / $494.18 / $1,789.34	Professional		$344.36	$494.18	$1,789.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.29 / $141.22 / $322.00	Professional	26	$85.29	$141.22	$322.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $165.71 / $236.09 / $894.67	Professional	52	$165.71	$236.09	$894.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $238.28 / $335.00 / $1,284.99	Professional	TC	$238.28	$335.00	$1,284.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.91 / $64.91 / $64.91	Professional	26	$64.91	$64.91	$64.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $180.59 / $180.59 / $180.59	Professional	TC	$180.59	$180.59	$180.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.24 / $352.15 / $474.32	Professional		$269.24	$352.15	$474.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.29 / $79.69 / $131.12	Professional	26	$78.29	$79.69	$131.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $189.54 / $247.92 / $394.46	Professional	TC	$189.54	$247.92	$394.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.99 / $471.59 / $840.40	Professional		$276.99	$471.59	$840.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.55 / $108.85 / $158.87	Professional	26	$70.55	$108.85	$158.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.37 / $370.39 / $739.00	Professional	TC	$194.37	$370.39	$739.00
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $5.58 / $385.31 / $616.50	Professional		$5.58	$385.31	$616.50
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.08 / $105.76 / $142.36	Professional	26	$1.08	$105.76	$142.36
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.50 / $273.83 / $488.96	Professional	TC	$4.50	$273.83	$488.96
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $5.58 / $265.98 / $403.13	Professional		$5.58	$265.98	$403.13
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.08 / $81.34 / $122.03	Professional	26	$1.08	$81.34	$122.03
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.50 / $281.10 / $293.39	Professional	TC	$4.50	$281.10	$293.39
United Facility/Professional Professional Modifier Low / Median / High Price $266.58 / $470.43 / $755.48	Professional		$266.58	$470.43	$755.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.66 / $82.46 / $167.68	Professional	26	$68.66	$82.46	$167.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $188.57 / $302.44 / $656.03	Professional	TC	$188.57	$302.44	$656.03