Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $38.90 / $47.86	Facility	26	$38.90	$38.90	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $114.82 / $165.96	Professional		$87.10	$114.82	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $70.79 / $114.82	Professional	TC	$53.70	$70.79	$114.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $104.71 / $169.82	Professional		$89.13	$104.71	$169.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $67.61 / $104.71	Professional	TC	$48.98	$67.61	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $151.36 / $257.04	Professional		$95.50	$151.36	$257.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $107.15 / $194.98	Professional	TC	$60.26	$107.15	$194.98
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.93 / $131.83 / $181.97	Professional		$0.93	$131.83	$181.97
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.38 / $47.86 / $63.10	Professional	26	$0.38	$47.86	$63.10
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.55 / $85.11 / $117.49	Professional	TC	$0.55	$85.11	$117.49
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.93 / $0.93 / $165.96	Professional		$0.93	$0.93	$165.96
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.55 / $0.55 / $104.71	Professional	TC	$0.55	$0.55	$104.71
Select Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $109.65 / $109.65	Professional		$104.71	$109.65	$109.65
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $70.79 / $70.79	Professional	TC	$66.07	$70.79	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $125.89 / $218.78	Professional		$93.33	$125.89	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $72.44 / $158.49	Professional	TC	$56.23	$72.44	$158.49