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 / $83.18	Facility	26	$70.79	$70.79	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $275.42 / $602.56	Professional		$173.78	$275.42	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $70.79 / $288.40	Professional	26	$53.70	$70.79	$288.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $173.78 / $302.00	Professional	TC	$114.82	$173.78	$302.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Professional		$251.19	$251.19	$251.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $44.67 / $87.10	Professional	26	$42.66	$44.67	$87.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $199.53 / $302.00	Professional		$169.82	$199.53	$302.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $54.95 / $97.72	Professional	26	$53.70	$54.95	$97.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $138.04 / $223.87	Professional	TC	$112.20	$138.04	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $288.40 / $478.63	Professional		$173.78	$288.40	$478.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $72.44 / $107.15	Professional	26	$44.67	$72.44	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $204.17 / $389.05	Professional	TC	$117.49	$204.17	$389.05
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.69 / $218.78 / $288.40	Professional		$2.69	$218.78	$288.40
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $67.61 / $89.13	Professional	26	$0.63	$67.61	$89.13
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $147.91 / $199.53	Professional	TC	$85.11	$147.91	$199.53
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.69 / $2.69 / $251.19	Professional		$2.69	$2.69	$251.19
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $0.63 / $83.18	Professional	26	$0.63	$0.63	$83.18
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $151.36 / $169.82	Professional	TC	$151.36	$151.36	$169.82
Select Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $169.82 / $169.82	Professional		$165.96	$169.82	$169.82
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $56.23 / $56.23	Professional	26	$54.95	$56.23	$56.23
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $112.20 / $112.20	Professional	TC	$112.20	$112.20	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $251.19 / $407.38	Professional		$169.82	$251.19	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $53.70 / $102.33	Professional	26	$43.65	$53.70	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $162.18 / $338.84	Professional	TC	$109.65	$162.18	$338.84