Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.25 / $118.23 / $141.88	Facility	26	$67.25	$118.23	$141.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.99 / $475.00 / $1,266.70	Professional		$208.99	$475.00	$1,266.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.18 / $158.34 / $388.00	Professional	26	$73.18	$158.34	$388.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $122.86 / $187.50 / $1,224.19	Professional	52	$122.86	$187.50	$1,224.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $129.40 / $335.00 / $812.00	Professional	TC	$129.40	$335.00	$812.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $145.09 / $150.24 / $285.45	Professional		$145.09	$150.24	$285.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.80 / $102.22 / $146.54	Professional	26	$53.80	$102.22	$146.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $146.94 / $146.94 / $146.94	Professional	TC	$146.94	$146.94	$146.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.50 / $254.03 / $391.60	Professional		$190.50	$254.03	$391.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.09 / $66.67 / $111.33	Professional	26	$65.09	$66.67	$111.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.82 / $161.94 / $318.83	Professional	TC	$123.82	$161.94	$318.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.88 / $363.78 / $721.97	Professional		$195.88	$363.78	$721.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.68 / $90.57 / $134.50	Professional	26	$58.68	$90.57	$134.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $127.20 / $243.37 / $618.07	Professional	TC	$127.20	$243.37	$618.07
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.95 / $275.47 / $482.36	Professional		$4.95	$275.47	$482.36
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.90 / $88.45 / $119.07	Professional	26	$0.90	$88.45	$119.07
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.05 / $180.08 / $409.99	Professional	TC	$4.05	$180.08	$409.99
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.95 / $187.80 / $286.95	Professional		$4.95	$187.80	$286.95
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.90 / $68.04 / $102.06	Professional	26	$0.90	$68.04	$102.06
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.05 / $184.89 / $192.95	Professional	TC	$4.05	$184.89	$192.95
United Facility/Professional Professional Modifier Low / Median / High Price $187.74 / $367.15 / $651.37	Professional		$187.74	$367.15	$651.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.87 / $68.23 / $140.88	Professional	26	$53.87	$68.23	$140.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.00 / $196.98 / $564.08	Professional	TC	$123.00	$196.98	$564.08