Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.28 / $73.00 / $139.88	Facility	26	$66.28	$73.00	$139.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $294.20 / $475.00 / $1,679.00	Professional		$294.20	$475.00	$1,679.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.05 / $140.00 / $414.08	Professional	26	$73.05	$140.00	$414.08
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $140.41 / $202.17 / $771.22	Professional	52	$140.41	$202.17	$771.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $198.79 / $335.00 / $1,098.88	Professional	TC	$198.79	$335.00	$1,098.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $172.31 / $179.22 / $219.70	Professional		$172.31	$179.22	$219.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.33 / $100.75 / $144.41	Professional	26	$53.33	$100.75	$144.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $230.50 / $308.33 / $393.85	Professional		$230.50	$308.33	$393.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.12 / $65.72 / $107.45	Professional	26	$64.12	$65.72	$107.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $164.78 / $224.24 / $325.22	Professional	TC	$164.78	$224.24	$325.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $241.29 / $406.49 / $762.37	Professional		$241.29	$406.49	$762.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.45 / $84.76 / $131.15	Professional	26	$52.45	$84.76	$131.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.73 / $327.88 / $627.00	Professional	TC	$172.73	$327.88	$627.00
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.95 / $327.56 / $517.40	Professional		$4.95	$327.56	$517.40
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.90 / $86.36 / $116.25	Professional	26	$0.90	$86.36	$116.25
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.05 / $219.66 / $425.00	Professional	TC	$4.05	$219.66	$425.00
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.95 / $224.03 / $341.21	Professional		$4.95	$224.03	$341.21
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.90 / $66.43 / $99.65	Professional	26	$0.90	$66.43	$99.65
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.05 / $205.94 / $241.56	Professional	TC	$4.05	$205.94	$241.56
United Facility/Professional Professional Modifier Low / Median / High Price $229.76 / $388.47 / $653.84	Professional		$229.76	$388.47	$653.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.76 / $70.72 / $138.88	Professional	26	$56.76	$70.72	$138.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.94 / $302.55 / $567.41	Professional	TC	$165.94	$302.55	$567.41