Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.08 / $64.94 / $614.04	Facility	26	$45.08	$64.94	$614.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.59 / $220.95 / $978.22	Professional		$107.59	$220.95	$978.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.61 / $71.86 / $248.00	Professional	26	$46.61	$71.86	$248.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $127.89 / $201.03 / $648.75	Professional	TC	$127.89	$201.03	$648.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.32 / $121.32 / $154.79	Professional		$121.32	$121.32	$154.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.07 / $66.72 / $98.23	Professional	26	$36.07	$66.72	$98.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.97 / $195.59 / $275.58	Professional		$158.97	$195.59	$275.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.76 / $47.90 / $73.65	Professional	26	$44.76	$47.90	$73.65
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $224.43 / $264.04 / $523.60	Professional	50	$224.43	$264.04	$523.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $109.74 / $138.57 / $199.09	Professional	TC	$109.74	$138.57	$199.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $152.87 / $256.22 / $378.35	Professional		$152.87	$256.22	$378.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.64 / $63.62 / $90.17	Professional	26	$39.64	$63.62	$90.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.92 / $185.21 / $301.18	Professional	TC	$112.92	$185.21	$301.18
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.06 / $214.17 / $278.45	Professional		$2.06	$214.17	$278.45
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.54 / $59.93 / $80.68	Professional	26	$0.54	$59.93	$80.68
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.53 / $138.94 / $216.05	Professional	TC	$1.53	$138.94	$216.05
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.06 / $152.97 / $229.47	Professional		$2.06	$152.97	$229.47
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.54 / $46.10 / $69.15	Professional	26	$0.54	$46.10	$69.15
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.53 / $89.34 / $160.32	Professional	TC	$1.53	$89.34	$160.32
United Facility/Professional Professional Modifier Low / Median / High Price $154.30 / $198.13 / $337.27	Professional		$154.30	$198.13	$337.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.22 / $47.44 / $93.28	Professional	26	$39.22	$47.44	$93.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.73 / $148.12 / $252.56	Professional	TC	$110.73	$148.12	$252.56