Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $61.66 / $74.13	Facility	26	$61.66	$61.66	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $213.80 / $691.83	Professional		$131.83	$213.80	$691.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $58.88 / $194.98	Professional	26	$47.86	$58.88	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $125.89 / $288.40	Professional	TC	$83.18	$125.89	$288.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $104.71 / $169.82	Professional		$89.13	$104.71	$169.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $39.81 / $75.86	Professional	26	$38.02	$39.81	$75.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $151.36 / $234.42	Professional		$131.83	$151.36	$234.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $48.98 / $87.10	Professional	26	$47.86	$48.98	$87.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $95.50 / $169.82	Professional	TC	$83.18	$95.50	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $213.80 / $380.19	Professional		$128.82	$213.80	$380.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $64.57 / $91.20	Professional	26	$38.90	$64.57	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $147.91 / $295.12	Professional	TC	$85.11	$147.91	$295.12
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.29 / $165.96 / $223.87	Professional		$2.29	$165.96	$223.87
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.54 / $58.88 / $79.43	Professional	26	$0.54	$58.88	$79.43
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $107.15 / $141.25	Professional	TC	$53.70	$107.15	$141.25
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.29 / $2.29 / $199.53	Professional		$2.29	$2.29	$199.53
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.54 / $0.54 / $74.13	Professional	26	$0.54	$0.54	$74.13
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $89.13 / $123.03	Professional	TC	$89.13	$89.13	$123.03
Select Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Professional		$131.83	$131.83	$131.83
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $48.98 / $48.98	Professional	26	$48.98	$48.98	$48.98
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $83.18 / $83.18	Professional	TC	$81.28	$83.18	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $186.21 / $338.84	Professional		$125.89	$186.21	$338.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $47.86 / $91.20	Professional	26	$38.90	$47.86	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $109.65 / $269.15	Professional	TC	$74.13	$109.65	$269.15