Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $181.97 / $218.78	Facility	26	$181.97	$181.97	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $478.63 / $1,737.80	Professional		$338.84	$478.63	$1,737.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $173.78 / $602.56	Professional	26	$107.15	$173.78	$602.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $338.84 / $676.08	Professional	TC	$229.09	$338.84	$676.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $257.04 / $478.63	Professional		$213.80	$257.04	$478.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $89.13 / $194.98	Professional	26	$81.28	$89.13	$194.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $154.88 / $154.88	Professional	TC	$154.88	$154.88	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $371.54 / $616.60	Professional		$323.59	$371.54	$616.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $112.20 / $181.97	Professional	26	$102.33	$112.20	$181.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $251.19 / $501.19	Professional	TC	$218.78	$251.19	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $549.54 / $1,258.93	Professional		$323.59	$549.54	$1,258.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $147.91 / $208.93	Professional	26	$81.28	$147.91	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $389.05 / $1,096.48	Professional	TC	$223.87	$389.05	$1,096.48
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $6.31 / $416.87 / $562.34	Professional		$6.31	$416.87	$562.34
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.35 / $125.89 / $169.82	Professional	26	$1.35	$125.89	$169.82
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $281.84 / $371.54	Professional	TC	$158.49	$281.84	$371.54
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $6.31 / $6.31 / $478.63	Professional		$6.31	$6.31	$478.63
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.35 / $1.35 / $158.49	Professional	26	$1.35	$1.35	$158.49
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $302.00 / $323.59	Professional	TC	$302.00	$302.00	$323.59
Select Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Professional		$316.23	$316.23	$316.23
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $104.71 / $104.71	Professional	26	$104.71	$104.71	$104.71
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $213.80 / $213.80	Professional	TC	$208.93	$213.80	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $489.78 / $1,174.90	Professional		$316.23	$489.78	$1,174.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $104.71 / $194.98	Professional	26	$91.20	$104.71	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $309.03 / $933.25	Professional	TC	$204.17	$309.03	$933.25