Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $141.25 / $169.82	Facility	26	$141.25	$141.25	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $501.19 / $2,187.76	Professional		$354.81	$501.19	$2,187.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $131.83 / $331.13	Professional	26	$85.11	$131.83	$331.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $338.84 / $562.34	Professional	TC	$257.04	$338.84	$562.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $75.86 / $75.86	Professional	26	$75.86	$75.86	$75.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $389.05 / $602.56	Professional		$338.84	$389.05	$602.56
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $79.43 / $141.25	Professional	26	$79.43	$79.43	$141.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $295.12 / $457.09	Professional	TC	$257.04	$295.12	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $537.03 / $831.76	Professional		$331.13	$537.03	$831.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $104.71 / $162.18	Professional	26	$64.57	$104.71	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $416.87 / $676.08	Professional	TC	$263.03	$416.87	$676.08
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $5.25 / $436.52 / $562.34	Professional		$5.25	$436.52	$562.34
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.00 / $97.72 / $131.83	Professional	26	$1.00	$97.72	$131.83
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.27 / $331.13 / $426.58	Professional	TC	$4.27	$331.13	$426.58
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $5.25 / $5.25 / $501.19	Professional		$5.25	$5.25	$501.19
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.00 / $1.00 / $123.03	Professional	26	$1.00	$1.00	$123.03
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.27 / $4.27 / $380.19	Professional	TC	$4.27	$4.27	$380.19
Select Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $338.84 / $338.84	Professional		$331.13	$338.84	$338.84
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $81.28 / $81.28	Professional	26	$81.28	$81.28	$81.28
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $251.19 / $251.19	Professional	TC	$251.19	$251.19	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $446.68 / $724.44	Professional		$331.13	$446.68	$724.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $77.62 / $147.91	Professional	26	$64.57	$77.62	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $363.08 / $588.84	Professional	TC	$239.88	$363.08	$588.84