Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.30 / $102.70 / $123.24	Facility	26	$82.30	$102.70	$123.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.11 / $438.48 / $1,565.46	Professional		$313.11	$438.48	$1,565.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.23 / $103.91 / $463.00	Professional	26	$82.23	$103.91	$463.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $210.41 / $310.24 / $882.03	Professional	TC	$210.41	$310.24	$882.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $231.06 / $231.06 / $231.06	Professional		$231.06	$231.06	$231.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.45 / $179.33 / $179.33	Professional	26	$66.45	$179.33	$179.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $281.10 / $330.71 / $519.71	Professional		$281.10	$330.71	$519.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.64 / $83.88 / $131.85	Professional	26	$80.64	$83.88	$131.85
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $193.61 / $228.12 / $381.92	Professional	TC	$193.61	$228.12	$381.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.00 / $470.00 / $796.93	Professional		$275.00	$470.00	$796.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.61 / $105.25 / $160.75	Professional	26	$64.61	$105.25	$160.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.15 / $342.79 / $581.29	Professional	TC	$210.15	$342.79	$581.29
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.06 / $346.35 / $541.17	Professional		$3.06	$346.35	$541.17
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.81 / $107.35 / $144.52	Professional	26	$0.81	$107.35	$144.52
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.25 / $232.83 / $389.60	Professional	TC	$2.25	$232.83	$389.60
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.06 / $261.67 / $392.51	Professional		$3.06	$261.67	$392.51
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.81 / $82.58 / $123.87	Professional	26	$0.81	$82.58	$123.87
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.25 / $152.36 / $268.64	Professional	TC	$2.25	$152.36	$268.64
United Facility/Professional Professional Modifier Low / Median / High Price $271.72 / $392.60 / $642.40	Professional		$271.72	$392.60	$642.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.20 / $83.18 / $170.32	Professional	26	$68.20	$83.18	$170.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $195.01 / $293.86 / $536.79	Professional	TC	$195.01	$293.86	$536.79