Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $123.03 / $147.91	Facility	26	$123.03	$123.03	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $489.78 / $1,023.29	Professional		$346.74	$489.78	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $123.03 / $446.68	Professional	26	$85.11	$123.03	$446.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $354.81 / $537.03	Professional	TC	$223.87	$354.81	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $309.03 / $562.34	Professional		$257.04	$309.03	$562.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $83.18 / $162.18	Professional	26	$77.62	$83.18	$162.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $436.52 / $676.08	Professional		$380.19	$436.52	$676.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $97.72 / $173.78	Professional	26	$91.20	$97.72	$173.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $323.59 / $501.19	Professional	TC	$281.84	$323.59	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $562.34 / $831.76	Professional		$323.59	$562.34	$831.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $120.23 / $177.83	Professional	26	$77.62	$120.23	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $426.58 / $645.65	Professional	TC	$239.88	$426.58	$645.65
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.68 / $467.74 / $602.56	Professional		$4.68	$467.74	$602.56
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.23 / $120.23 / $158.49	Professional	26	$1.23	$120.23	$158.49
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $346.74 / $446.68	Professional	TC	$181.97	$346.74	$446.68
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.68 / $4.68 / $562.34	Professional		$4.68	$4.68	$562.34
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.23 / $1.23 / $151.36	Professional	26	$1.23	$1.23	$151.36
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $302.00 / $416.87	Professional	TC	$302.00	$302.00	$416.87
Select Health Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $380.19 / $380.19	Professional		$371.54	$380.19	$380.19
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Professional	26	$100.00	$100.00	$100.00
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $275.42 / $275.42	Professional	TC	$275.42	$275.42	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $467.74 / $776.25	Professional		$331.13	$467.74	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $100.00 / $181.97	Professional	26	$87.10	$100.00	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $354.81 / $588.84	Professional	TC	$239.88	$354.81	$588.84