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 $288.40 / $457.09 / $870.96	Professional		$288.40	$457.09	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $131.83 / $426.58	Professional	26	$85.11	$131.83	$426.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $316.23 / $562.34	Professional	TC	$194.98	$316.23	$562.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $66.07 / $75.86	Professional	26	$66.07	$66.07	$75.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $309.03 / $478.63	Professional		$269.15	$309.03	$478.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $79.43 / $141.25	Professional	26	$77.62	$79.43	$141.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $218.78 / $398.11	Professional	TC	$190.55	$218.78	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $467.74 / $851.14	Professional		$275.42	$467.74	$851.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $107.15 / $162.18	Professional	26	$64.57	$107.15	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $346.74 / $741.31	Professional	TC	$194.98	$346.74	$741.31
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $5.62 / $346.74 / $467.74	Professional		$5.62	$346.74	$467.74
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.07 / $97.72 / $131.83	Professional	26	$1.07	$97.72	$131.83
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $251.19 / $354.81	Professional	TC	$147.91	$251.19	$354.81
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 $281.84 / $281.84 / $295.12	Professional	TC	$281.84	$281.84	$295.12
Select Health Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $269.15 / $269.15	Professional		$263.03	$269.15	$269.15
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $81.28 / $81.28	Professional	26	$81.28	$81.28	$81.28
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $186.21 / $186.21	Professional	TC	$186.21	$186.21	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $416.87 / $758.58	Professional		$269.15	$416.87	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $77.62 / $147.91	Professional	26	$64.57	$77.62	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $269.15 / $660.69	Professional	TC	$177.83	$269.15	$660.69