Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $169.82 / $204.17	Facility	26	$169.82	$169.82	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $524.81 / $1,698.24	Professional		$371.54	$524.81	$1,698.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $141.25 / $524.81	Professional	26	$102.33	$141.25	$524.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $416.87 / $1,000.00	Professional	TC	$302.00	$416.87	$1,000.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $309.03 / $616.60	Professional		$269.15	$309.03	$616.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $79.43 / $147.91	Professional	26	$75.86	$79.43	$147.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $467.74 / $741.31	Professional		$416.87	$467.74	$741.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $95.50 / $169.82	Professional	26	$93.33	$95.50	$169.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $371.54 / $562.34	Professional	TC	$316.23	$371.54	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $660.69 / $1,288.25	Professional		$398.11	$660.69	$1,288.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $120.23 / $190.55	Professional	26	$72.44	$120.23	$190.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $524.81 / $954.99	Professional	TC	$323.59	$524.81	$954.99
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $6.31 / $524.81 / $691.83	Professional		$6.31	$524.81	$691.83
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.35 / $117.49 / $158.49	Professional	26	$1.35	$117.49	$158.49
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $389.05 / $524.81	Professional	TC	$181.97	$389.05	$524.81
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $6.31 / $6.31 / $616.60	Professional		$6.31	$6.31	$616.60
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.35 / $1.35 / $147.91	Professional	26	$1.35	$1.35	$147.91
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $302.00 / $457.09	Professional	TC	$302.00	$302.00	$457.09
Select Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $407.38 / $407.38	Professional		$398.11	$407.38	$407.38
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $100.00 / $100.00	Professional	26	$97.72	$100.00	$100.00
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $309.03 / $309.03	Professional	TC	$302.00	$309.03	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $562.34 / $1,202.26	Professional		$371.54	$562.34	$1,202.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $93.33 / $177.83	Professional	26	$77.62	$93.33	$177.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $457.09 / $977.24	Professional	TC	$295.12	$457.09	$977.24