Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.77 / $68.47 / $82.16	Facility	26	$53.77	$68.47	$82.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.40 / $249.83 / $837.90	Professional		$155.40	$249.83	$837.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.28 / $85.66 / $243.00	Professional	26	$51.28	$85.66	$243.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.28 / $172.62 / $509.77	Professional	TC	$99.28	$172.62	$509.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.61 / $103.61 / $131.61	Professional		$103.61	$103.61	$131.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.15 / $43.15 / $99.34	Professional	26	$43.15	$43.15	$99.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.30 / $165.75 / $235.62	Professional		$134.30	$165.75	$235.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.35 / $53.65 / $88.28	Professional	26	$52.35	$53.65	$88.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.31 / $99.84 / $168.90	Professional	TC	$80.31	$99.84	$168.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.28 / $222.38 / $378.33	Professional		$138.28	$222.38	$378.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.10 / $72.14 / $107.17	Professional	26	$47.10	$72.14	$107.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.44 / $147.55 / $285.88	Professional	TC	$82.44	$147.55	$285.88
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.25 / $188.55 / $250.00	Professional		$2.25	$188.55	$250.00
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $70.72 / $95.20	Professional	26	$0.63	$70.72	$95.20
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.62 / $105.98 / $162.06	Professional	TC	$1.62	$105.98	$162.06
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.25 / $133.94 / $203.88	Professional		$2.25	$133.94	$203.88
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $54.40 / $81.59	Professional	26	$0.63	$54.40	$81.59
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.62 / $89.34 / $122.28	Professional	TC	$1.62	$89.34	$122.28
United Facility/Professional Professional Modifier Low / Median / High Price $128.84 / $197.61 / $328.68	Professional		$128.84	$197.61	$328.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.95 / $53.91 / $111.00	Professional	26	$45.95	$53.91	$111.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.47 / $99.65 / $262.24	Professional	TC	$72.47	$99.65	$262.24