Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $87.10	Facility	26	$72.44	$72.44	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $275.42 / $436.52	Professional		$199.53	$275.42	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $64.57 / $120.23	Professional	26	$52.48	$64.57	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $190.55 / $338.84	Professional	TC	$141.25	$190.55	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $194.98	Professional		$131.83	$131.83	$194.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $46.77 / $56.23	Professional	26	$45.71	$46.77	$56.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $239.88 / $346.74	Professional		$194.98	$239.88	$346.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $57.54 / $102.33	Professional	26	$56.23	$57.54	$102.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $177.83 / $281.84	Professional	TC	$138.04	$177.83	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $338.84 / $562.34	Professional		$204.17	$338.84	$562.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $75.86 / $114.82	Professional	26	$46.77	$75.86	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $251.19 / $478.63	Professional	TC	$144.54	$251.19	$478.63
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.24 / $257.04 / $331.13	Professional		$3.24	$257.04	$331.13
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.65 / $69.18 / $93.33	Professional	26	$0.65	$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 $3.24 / $3.24 / $295.12	Professional		$3.24	$3.24	$295.12
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.65 / $0.65 / $87.10	Professional	26	$0.65	$0.65	$87.10
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 $194.98 / $194.98 / $194.98	Professional		$194.98	$194.98	$194.98
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $57.54 / $57.54	Professional	26	$57.54	$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 $45.71 / $54.95 / $104.71	Professional	26	$45.71	$54.95	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $199.53 / $426.58	Professional	TC	$134.90	$199.53	$426.58