Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $67.61 / $81.28	Facility	26	$67.61	$67.61	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $223.87 / $724.44	Professional		$134.90	$223.87	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $67.61 / $223.87	Professional	26	$51.29	$67.61	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $128.82 / $338.84	Professional	TC	$81.28	$128.82	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $102.33 / $134.90	Professional		$91.20	$102.33	$134.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $43.65 / $91.20	Professional	26	$41.69	$43.65	$91.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $141.25 / $239.88	Professional		$134.90	$141.25	$239.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $53.70 / $95.50	Professional	26	$52.48	$53.70	$95.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $85.11 / $169.82	Professional	TC	$81.28	$85.11	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $223.87 / $380.19	Professional		$131.83	$223.87	$380.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $70.79 / $100.00	Professional	26	$43.65	$70.79	$100.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $147.91 / $288.40	Professional	TC	$83.18	$147.91	$288.40
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.24 / $169.82 / $229.09	Professional		$2.24	$169.82	$229.09
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $64.57 / $87.10	Professional	26	$0.63	$64.57	$87.10
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $104.71 / $134.90	Professional	TC	$53.70	$104.71	$134.90
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.24 / $2.24 / $204.17	Professional		$2.24	$2.24	$204.17
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $0.63 / $81.28	Professional	26	$0.63	$0.63	$81.28
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $89.13 / $123.03	Professional	TC	$89.13	$89.13	$123.03
Select Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Professional		$134.90	$134.90	$134.90
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $54.95 / $54.95	Professional	26	$53.70	$54.95	$54.95
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $81.28 / $81.28	Professional	TC	$79.43	$81.28	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $190.55 / $338.84	Professional		$128.82	$190.55	$338.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $52.48 / $100.00	Professional	26	$42.66	$52.48	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $107.15 / $263.03	Professional	TC	$74.13	$107.15	$263.03