Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $85.11	Facility	26	$70.79	$70.79	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $281.84 / $645.65	Professional		$199.53	$281.84	$645.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $72.44 / $245.47	Professional	26	$54.95	$72.44	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $213.80 / $416.87	Professional	TC	$141.25	$213.80	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $147.91 / $186.21	Professional		$64.57	$147.91	$186.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $45.71 / $93.33	Professional	26	$43.65	$45.71	$93.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $93.33 / $102.33	Professional	TC	$93.33	$93.33	$102.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $234.42 / $346.74	Professional		$194.98	$234.42	$346.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $60.26 / $100.00	Professional	26	$56.23	$60.26	$100.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $169.82 / $281.84	Professional	TC	$138.04	$169.82	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $338.84 / $562.34	Professional		$199.53	$338.84	$562.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $81.28 / $112.20	Professional	26	$45.71	$81.28	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $245.47 / $478.63	Professional	TC	$141.25	$245.47	$478.63
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.31 / $251.19 / $338.84	Professional		$3.31	$251.19	$338.84
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.78 / $69.18 / $93.33	Professional	26	$0.78	$69.18	$93.33
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $177.83 / $239.88	Professional	TC	$91.20	$177.83	$239.88
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.31 / $3.31 / $295.12	Professional		$3.31	$3.31	$295.12
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.78 / $0.78 / $85.11	Professional	26	$0.78	$0.78	$85.11
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $151.36 / $208.93	Professional	TC	$151.36	$151.36	$208.93
Select Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $194.98 / $194.98	Professional		$190.55	$194.98	$194.98
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $57.54 / $57.54	Professional	26	$56.23	$57.54	$57.54
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $138.04 / $138.04	Professional	TC	$134.90	$138.04	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $295.12 / $501.19	Professional		$194.98	$295.12	$501.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $60.26 / $112.20	Professional	26	$50.12	$60.26	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $194.98 / $426.58	Professional	TC	$131.83	$194.98	$426.58