Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.91 / $61.40 / $73.68	Facility	26	$48.91	$61.40	$73.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.73 / $221.75 / $802.00	Professional		$58.73	$221.75	$802.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.92 / $61.25 / $199.20	Professional	26	$45.92	$61.25	$199.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $66.95 / $82.31 / $456.88	Professional	52	$66.95	$82.31	$456.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.28 / $201.03 / $586.08	Professional	TC	$101.28	$201.03	$586.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.01 / $128.37 / $198.66	Professional		$101.01	$128.37	$198.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.13 / $74.34 / $106.57	Professional	26	$39.13	$74.34	$106.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.49 / $170.68 / $232.37	Professional		$130.49	$170.68	$232.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.26 / $51.08 / $79.40	Professional	26	$48.26	$51.08	$79.40
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $82.23 / $111.90 / $179.99	Professional	TC	$82.23	$111.90	$179.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.78 / $226.05 / $384.25	Professional		$135.78	$226.05	$384.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.98 / $67.88 / $96.68	Professional	26	$40.98	$67.88	$96.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.50 / $157.35 / $334.26	Professional	TC	$85.50	$157.35	$334.26
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.38 / $186.56 / $279.60	Professional		$2.38	$186.56	$279.60
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $62.65 / $85.94	Professional	26	$0.63	$62.65	$85.94
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.75 / $108.16 / $216.95	Professional	TC	$1.75	$108.16	$216.95
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.38 / $130.69 / $198.47	Professional		$2.38	$130.69	$198.47
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $49.11 / $73.67	Professional	26	$0.63	$49.11	$73.67
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.75 / $89.34 / $124.80	Professional	TC	$1.75	$89.34	$124.80
United Facility/Professional Professional Modifier Low / Median / High Price $136.51 / $200.25 / $340.99	Professional		$136.51	$200.25	$340.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.54 / $52.27 / $105.13	Professional	26	$42.54	$52.27	$105.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.07 / $129.62 / $276.75	Professional	TC	$86.07	$129.62	$276.75