Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $141.25 / $169.82	Facility	26	$141.25	$141.25	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $478.63 / $1,071.52	Professional		$346.74	$478.63	$1,071.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $120.23 / $165.96	Professional	26	$85.11	$120.23	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $338.84 / $562.34	Professional	TC	$257.04	$338.84	$562.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $380.19 / $602.56	Professional		$331.13	$380.19	$602.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $79.43 / $141.25	Professional	26	$79.43	$79.43	$141.25
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $478.63 / $575.44 / $1,096.48	Professional	50	$478.63	$575.44	$1,096.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $295.12 / $457.09	Professional	TC	$257.04	$295.12	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $537.03 / $831.76	Professional		$331.13	$537.03	$831.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $107.15 / $162.18	Professional	26	$64.57	$107.15	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $416.87 / $676.08	Professional	TC	$263.03	$416.87	$676.08
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $5.25 / $436.52 / $562.34	Professional		$5.25	$436.52	$562.34
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.00 / $97.72 / $131.83	Professional	26	$1.00	$97.72	$131.83
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.27 / $331.13 / $436.52	Professional	TC	$4.27	$331.13	$436.52
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $5.25 / $5.25 / $501.19	Professional		$5.25	$5.25	$501.19
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.00 / $1.00 / $123.03	Professional	26	$1.00	$1.00	$123.03
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.27 / $4.27 / $380.19	Professional	TC	$4.27	$4.27	$380.19
Select Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $338.84 / $338.84	Professional		$331.13	$338.84	$338.84
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $83.18 / $83.18	Professional	26	$81.28	$83.18	$83.18
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $257.04 / $257.04	Professional	TC	$251.19	$257.04	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $446.68 / $724.44	Professional		$331.13	$446.68	$724.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $77.62 / $151.36	Professional	26	$66.07	$77.62	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $363.08 / $588.84	Professional	TC	$239.88	$363.08	$588.84