Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $57.54 / $69.18	Facility	26	$57.54	$57.54	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $218.78 / $512.86	Professional		$128.82	$218.78	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $54.95 / $223.87	Professional	26	$42.66	$54.95	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $138.04 / $295.12	Professional	TC	$83.18	$138.04	$295.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $104.71 / $199.53	Professional		$87.10	$104.71	$199.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $38.02 / $74.13	Professional	26	$35.48	$38.02	$74.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $154.88 / $234.42	Professional		$128.82	$154.88	$234.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $48.98 / $79.43	Professional	26	$44.67	$48.98	$79.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $102.33 / $181.97	Professional	TC	$83.18	$102.33	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $229.09 / $380.19	Professional		$131.83	$229.09	$380.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $64.57 / $91.20	Professional	26	$36.31	$64.57	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $158.49 / $309.03	Professional	TC	$87.10	$158.49	$309.03
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.34 / $169.82 / $229.09	Professional		$2.34	$169.82	$229.09
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.62 / $54.95 / $74.13	Professional	26	$0.62	$54.95	$74.13
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $109.65 / $147.91	Professional	TC	$53.70	$109.65	$147.91
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.34 / $2.34 / $194.98	Professional		$2.34	$2.34	$194.98
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.62 / $0.62 / $69.18	Professional	26	$0.62	$0.62	$69.18
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $89.13 / $125.89	Professional	TC	$89.13	$89.13	$125.89
Select Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $45.71 / $45.71	Professional	26	$44.67	$45.71	$45.71
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $85.11 / $85.11	Professional	TC	$83.18	$85.11	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $194.98 / $346.74	Professional		$128.82	$194.98	$346.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $46.77 / $83.18	Professional	26	$40.74	$46.77	$83.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $125.89 / $275.42	Professional	TC	$83.18	$125.89	$275.42