Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.48 / $108.79 / $130.55	Facility	26	$61.48	$108.79	$130.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.98 / $400.00 / $1,262.00	Professional		$218.98	$400.00	$1,262.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.00 / $140.00 / $377.00	Professional	26	$73.00	$140.00	$377.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,218.00 / $1,218.00 / $1,218.00	Professional	50	$1,218.00	$1,218.00	$1,218.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $123.88 / $187.50 / $665.13	Professional	52	$123.88	$187.50	$665.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $172.56 / $335.00 / $812.00	Professional	TC	$172.56	$335.00	$812.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.13 / $160.08 / $304.14	Professional		$154.13	$160.08	$304.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $49.37 / $90.41 / $133.96	Professional	26	$49.37	$90.41	$133.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $201.29 / $269.45 / $385.76	Professional		$201.29	$269.45	$385.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.36 / $61.27 / $101.09	Professional	26	$59.36	$61.27	$101.09
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $309.20 / $363.77 / $660.39	Professional	50	$309.20	$363.77	$660.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $140.01 / $183.13 / $318.83	Professional	TC	$140.01	$183.13	$318.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.91 / $383.86 / $675.93	Professional		$207.91	$383.86	$675.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.66 / $78.47 / $122.39	Professional	26	$48.66	$78.47	$122.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.77 / $277.23 / $598.04	Professional	TC	$144.77	$277.23	$598.04
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.95 / $286.64 / $370.50	Professional		$4.95	$286.64	$370.50
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.90 / $81.58 / $109.81	Professional	26	$0.90	$81.58	$109.81
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.05 / $192.21 / $284.89	Professional	TC	$4.05	$192.21	$284.89
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.95 / $200.09 / $307.11	Professional		$4.95	$200.09	$307.11
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.90 / $62.75 / $94.13	Professional	26	$0.90	$62.75	$94.13
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.05 / $205.94 / $212.97	Professional	TC	$4.05	$205.94	$212.97
United Facility/Professional Professional Modifier Low / Median / High Price $198.48 / $350.25 / $626.55	Professional		$198.48	$350.25	$626.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.86 / $59.82 / $129.19	Professional	26	$50.86	$59.82	$129.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.66 / $195.76 / $551.76	Professional	TC	$138.66	$195.76	$551.76