Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $79.43 / $95.50	Facility	26	$79.43	$79.43	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $338.84 / $1,122.02	Professional		$234.42	$338.84	$1,122.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $85.11 / $263.03	Professional	26	$57.54	$85.11	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $239.88 / $524.81	Professional	TC	$169.82	$239.88	$524.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $194.98 / $371.54	Professional		$162.18	$194.98	$371.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $50.12 / $109.65	Professional	26	$48.98	$50.12	$109.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	TC	$144.54	$144.54	$144.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $275.42 / $467.74	Professional		$263.03	$275.42	$467.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $63.10 / $112.20	Professional	26	$61.66	$63.10	$112.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $204.17 / $354.81	Professional	TC	$199.53	$204.17	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $389.05 / $630.96	Professional		$234.42	$389.05	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $83.18 / $123.03	Professional	26	$51.29	$83.18	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $309.03 / $512.86	Professional	TC	$190.55	$309.03	$512.86
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.24 / $302.00 / $407.38	Professional		$3.24	$302.00	$407.38
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.72 / $75.86 / $102.33	Professional	26	$0.72	$75.86	$102.33
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $213.80 / $302.00	Professional	TC	$91.20	$213.80	$302.00
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.24 / $3.24 / $363.08	Professional		$3.24	$3.24	$363.08
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.72 / $0.72 / $95.50	Professional	26	$0.72	$0.72	$95.50
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $151.36 / $269.15	Professional	TC	$151.36	$151.36	$269.15
Select Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $245.47 / $245.47	Professional		$239.88	$245.47	$245.47
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $63.10 / $63.10	Professional	26	$63.10	$63.10	$63.10
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $177.83 / $177.83	Professional	TC	$177.83	$177.83	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $338.84 / $537.03	Professional		$229.09	$338.84	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $61.66 / $114.82	Professional	26	$50.12	$61.66	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $251.19 / $457.09	Professional	TC	$169.82	$251.19	$457.09