Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.00 / $104.15 / $217.27	Facility	26	$73.00	$104.15	$217.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $334.68 / $475.00 / $2,113.04	Professional		$334.68	$475.00	$2,113.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.69 / $200.20 / $518.00	Professional	26	$111.69	$200.20	$518.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $195.49 / $278.89 / $1,056.52	Professional	52	$195.49	$278.89	$1,056.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.19 / $374.08 / $1,464.67	Professional	TC	$269.19	$374.08	$1,464.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.35 / $250.62 / $250.62	Professional		$169.35	$250.62	$250.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.32 / $158.31 / $226.94	Professional	26	$83.32	$158.31	$226.94
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $203.93 / $203.93 / $203.93	Professional	TC	$203.93	$203.93	$203.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $317.81 / $415.69 / $603.79	Professional		$317.81	$415.69	$603.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.23 / $103.41 / $174.68	Professional	26	$102.23	$103.41	$174.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $215.58 / $281.98 / $488.56	Professional	TC	$215.58	$281.98	$488.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.10 / $557.37 / $1,304.70	Professional		$326.10	$557.37	$1,304.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.87 / $143.87 / $203.70	Professional	26	$90.87	$143.87	$203.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.93 / $418.26 / $1,131.38	Professional	TC	$220.93	$418.26	$1,131.38
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $6.30 / $451.00 / $721.60	Professional		$6.30	$451.00	$721.60
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.35 / $135.86 / $182.89	Professional	26	$1.35	$135.86	$182.89
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.95 / $296.52 / $557.26	Professional	TC	$4.95	$296.52	$557.26
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $6.30 / $313.27 / $474.48	Professional		$6.30	$313.27	$474.48
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.35 / $104.51 / $156.77	Professional	26	$1.35	$104.51	$156.77
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.95 / $301.58 / $317.72	Professional	TC	$4.95	$301.58	$317.72
United Facility/Professional Professional Modifier Low / Median / High Price $282.45 / $462.15 / $1,201.78	Professional		$282.45	$462.15	$1,201.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.82 / $108.71 / $215.39	Professional	26	$85.82	$108.71	$215.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $215.33 / $380.02 / $985.16	Professional	TC	$215.33	$380.02	$985.16