Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.47 / $65.80 / $78.95	Facility	26	$52.47	$65.80	$78.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $267.55 / $314.02 / $1,230.00	Professional		$267.55	$314.02	$1,230.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.02 / $83.57 / $237.00	Professional	26	$52.02	$83.57	$237.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $209.87 / $227.53 / $442.83	Professional	TC	$209.87	$227.53	$442.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $170.60 / $170.60 / $218.28	Professional		$170.60	$170.60	$218.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.98 / $77.66 / $114.33	Professional	26	$41.98	$77.66	$114.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $230.82 / $258.86 / $381.91	Professional		$230.82	$258.86	$381.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.08 / $51.75 / $86.93	Professional	26	$51.08	$51.75	$86.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $179.07 / $207.78 / $305.97	Professional	TC	$179.07	$207.78	$305.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.14 / $331.88 / $495.99	Professional		$207.14	$331.88	$495.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.95 / $70.59 / $102.99	Professional	26	$45.95	$70.59	$102.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.47 / $258.69 / $406.91	Professional	TC	$157.47	$258.69	$406.91
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.57 / $293.11 / $380.66	Professional		$2.57	$293.11	$380.66
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.59 / $68.98 / $92.86	Professional	26	$0.59	$68.98	$92.86
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.98 / $224.13 / $293.45	Professional	TC	$1.98	$224.13	$293.45
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.57 / $222.84 / $338.21	Professional		$2.57	$222.84	$338.21
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.59 / $53.06 / $79.59	Professional	26	$0.59	$53.06	$79.59
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.98 / $152.36 / $258.62	Professional	TC	$1.98	$152.36	$258.62
United Facility/Professional Professional Modifier Low / Median / High Price $201.88 / $250.67 / $454.67	Professional		$201.88	$250.67	$454.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.40 / $59.19 / $109.50	Professional	26	$45.40	$59.19	$109.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $152.25 / $206.80 / $351.55	Professional	TC	$152.25	$206.80	$351.55