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 $196.00 / $375.00 / $1,214.00	Professional		$196.00	$375.00	$1,214.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.73 / $140.00 / $383.58	Professional	26	$67.73	$140.00	$383.58
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $123.69 / $187.50 / $662.98	Professional	52	$123.69	$187.50	$662.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $164.81 / $335.00 / $942.38	Professional	TC	$164.81	$335.00	$942.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.91 / $159.82 / $303.64	Professional		$79.91	$159.82	$303.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.60 / $95.29 / $133.96	Professional	26	$50.60	$95.29	$133.96
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $134.86 / $134.86 / $134.86	Professional	TC	$134.86	$134.86	$134.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $200.97 / $262.87 / $385.76	Professional		$200.97	$262.87	$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 $308.72 / $363.20 / $659.34	Professional	50	$308.72	$363.20	$659.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $139.69 / $182.72 / $318.83	Professional	TC	$139.69	$182.72	$318.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.58 / $392.50 / $703.00	Professional		$207.58	$392.50	$703.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.66 / $77.59 / $122.39	Professional	26	$48.66	$77.59	$122.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.36 / $274.52 / $618.00	Professional	TC	$144.36	$274.52	$618.00
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.95 / $285.70 / $370.50	Professional		$4.95	$285.70	$370.50
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.90 / $81.15 / $109.24	Professional	26	$0.90	$81.15	$109.24
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 / $199.77 / $306.11	Professional		$4.95	$199.77	$306.11
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.90 / $62.42 / $93.63	Professional	26	$0.90	$62.42	$93.63
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.05 / $205.94 / $212.48	Professional	TC	$4.05	$205.94	$212.48
United Facility/Professional Professional Modifier Low / Median / High Price $197.56 / $368.64 / $633.60	Professional		$197.56	$368.64	$633.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.32 / $61.25 / $127.24	Professional	26	$48.32	$61.25	$127.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.65 / $266.69 / $558.79	Professional	TC	$138.65	$266.69	$558.79