Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $102.33 / $123.03	Facility	26	$102.33	$102.33	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $354.81 / $1,412.54	Professional		$251.19	$354.81	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $95.50 / $234.42	Professional	26	$77.62	$95.50	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $223.87 / $407.38	Professional	TC	$169.82	$223.87	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $66.07 / $72.44	Professional	26	$63.10	$66.07	$72.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $537.03	Professional		$302.00	$302.00	$537.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $83.18 / $144.54	Professional	26	$81.28	$83.18	$144.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $223.87 / $398.11	Professional	TC	$223.87	$223.87	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $457.09 / $741.31	Professional		$263.03	$457.09	$741.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $100.00 / $147.91	Professional	26	$60.26	$100.00	$147.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $338.84 / $588.84	Professional	TC	$190.55	$338.84	$588.84
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.09 / $338.84 / $446.68	Professional		$3.09	$338.84	$446.68
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.81 / $100.00 / $134.90	Professional	26	$0.81	$100.00	$134.90
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $234.42 / $316.23	Professional	TC	$91.20	$234.42	$316.23
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.09 / $3.09 / $389.05	Professional		$3.09	$3.09	$389.05
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.81 / $0.81 / $123.03	Professional	26	$0.81	$0.81	$123.03
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 $263.03 / $263.03 / $263.03	Professional		$263.03	$263.03	$263.03
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $83.18 / $83.18	Professional	26	$83.18	$83.18	$83.18
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 $263.03 / $407.38 / $645.65	Professional		$263.03	$407.38	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $79.43 / $151.36	Professional	26	$67.61	$79.43	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $275.42 / $537.03	Professional	TC	$190.55	$275.42	$537.03