Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $141.25 / $169.82	Facility	26	$141.25	$141.25	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $457.09 / $870.96	Professional		$295.12	$457.09	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $128.82 / $269.15	Professional	26	$85.11	$128.82	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $323.59 / $562.34	Professional	TC	$199.53	$323.59	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Professional		$213.80	$213.80	$213.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $66.07 / $66.07	Professional	26	$66.07	$66.07	$66.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $309.03 / $489.78	Professional		$275.42	$309.03	$489.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $83.18 / $141.25	Professional	26	$79.43	$83.18	$141.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $223.87 / $398.11	Professional	TC	$194.98	$223.87	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $467.74 / $870.96	Professional		$275.42	$467.74	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $112.20 / $162.18	Professional	26	$64.57	$112.20	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $354.81 / $741.31	Professional	TC	$199.53	$354.81	$741.31
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $5.62 / $354.81 / $478.63	Professional		$5.62	$354.81	$478.63
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.07 / $97.72 / $134.90	Professional	26	$1.07	$97.72	$134.90
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $257.04 / $363.08	Professional	TC	$151.36	$257.04	$363.08
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $5.62 / $5.62 / $407.38	Professional		$5.62	$5.62	$407.38
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.07 / $1.07 / $123.03	Professional	26	$1.07	$1.07	$123.03
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $288.40 / $302.00	Professional	TC	$288.40	$288.40	$302.00
Select Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $275.42 / $275.42	Professional		$269.15	$275.42	$275.42
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $83.18 / $83.18	Professional	26	$81.28	$83.18	$83.18
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $190.55 / $190.55	Professional	TC	$190.55	$190.55	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $426.58 / $758.58	Professional		$275.42	$426.58	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $79.43 / $151.36	Professional	26	$69.18	$79.43	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $275.42 / $660.69	Professional	TC	$181.97	$275.42	$660.69