Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $28.18 / $34.67	Facility	26	$28.18	$28.18	$34.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $194.98	Professional		$89.13	$123.03	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $28.18 / $57.54	Professional	26	$22.91	$28.18	$57.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $93.33 / $151.36	Professional	TC	$66.07	$93.33	$151.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $21.38 / $21.38	Professional	26	$21.38	$21.38	$21.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $128.82 / $208.93	Professional		$91.20	$128.82	$208.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $26.92 / $46.77	Professional	26	$26.30	$26.92	$46.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $102.33 / $154.88	Professional	TC	$64.57	$102.33	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $138.04 / $234.42	Professional		$91.20	$138.04	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $33.11 / $52.48	Professional	26	$23.44	$33.11	$52.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $100.00 / $181.97	Professional	TC	$67.61	$100.00	$181.97
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.85 / $158.49 / $213.80	Professional		$0.85	$158.49	$213.80
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.32 / $33.88 / $44.67	Professional	26	$0.32	$33.88	$44.67
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.54 / $125.89 / $169.82	Professional	TC	$0.54	$125.89	$169.82
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.85 / $0.85 / $199.53	Professional		$0.85	$0.85	$199.53
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.32 / $0.32 / $42.66	Professional	26	$0.32	$0.32	$42.66
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.54 / $0.54 / $158.49	Professional	TC	$0.54	$0.54	$158.49
Select Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $131.83 / $131.83	Professional		$120.23	$131.83	$131.83
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $28.18 / $28.18	Professional	26	$26.92	$28.18	$28.18
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $104.71 / $104.71	Professional	TC	$93.33	$104.71	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $125.89 / $199.53	Professional		$75.86	$125.89	$199.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $30.20 / $50.12	Professional	26	$19.50	$30.20	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $95.50 / $147.91	Professional	TC	$56.23	$95.50	$147.91