Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.54 / $106.70 / $128.04	Facility	26	$85.54	$106.70	$128.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $297.16 / $392.31 / $688.45	Professional		$297.16	$392.31	$688.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.39 / $114.93 / $444.00	Professional	26	$82.39	$114.93	$444.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $210.15 / $310.45 / $761.34	Professional	TC	$210.15	$310.45	$761.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $155.51 / $155.51 / $311.01	Professional		$155.51	$155.51	$311.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.02 / $70.79 / $130.02	Professional	26	$69.02	$70.79	$130.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $289.07 / $350.21 / $549.01	Professional		$289.07	$350.21	$549.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.63 / $84.36 / $137.04	Professional	26	$80.63	$84.36	$137.04
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $411.92 / $484.62 / $892.70	Professional	50	$411.92	$484.62	$892.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $205.54 / $259.52 / $405.79	Professional	TC	$205.54	$259.52	$405.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $290.87 / $506.58 / $734.32	Professional		$290.87	$506.58	$734.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.01 / $106.36 / $167.01	Professional	26	$67.01	$106.36	$167.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.65 / $376.04 / $586.74	Professional	TC	$220.65	$376.04	$586.74
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.06 / $345.73 / $540.20	Professional		$3.06	$345.73	$540.20
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.81 / $112.05 / $150.83	Professional	26	$0.81	$112.05	$150.83
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.25 / $232.75 / $389.18	Professional	TC	$2.25	$232.75	$389.18
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.06 / $265.23 / $397.85	Professional		$3.06	$265.23	$397.85
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.81 / $86.19 / $129.29	Professional	26	$0.81	$86.19	$129.29
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.25 / $152.36 / $268.56	Professional	TC	$2.25	$152.36	$268.56
United Facility/Professional Professional Modifier Low / Median / High Price $306.64 / $401.01 / $680.01	Professional		$306.64	$401.01	$680.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $90.44 / $174.72	Professional	26	$72.44	$90.44	$174.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.90 / $312.14 / $514.36	Professional	TC	$223.90	$312.14	$514.36