Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $41.69 / $51.29	Facility	26	$41.69	$41.69	$51.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $141.25 / $630.96	Professional		$109.65	$141.25	$630.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $42.66 / $100.00	Professional	26	$30.90	$42.66	$100.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $100.00 / $199.53	Professional	TC	$79.43	$100.00	$199.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $169.82 / $173.78	Professional		$107.15	$169.82	$173.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $32.36 / $41.69	Professional	26	$31.62	$32.36	$41.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $138.04 / $223.87	Professional		$128.82	$138.04	$223.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $39.81 / $66.07	Professional	26	$37.15	$39.81	$66.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $95.50 / $162.18	Professional	TC	$93.33	$95.50	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $147.91 / $245.47	Professional		$102.33	$147.91	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $43.65 / $72.44	Professional	26	$30.20	$43.65	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $104.71 / $181.97	Professional	TC	$72.44	$104.71	$181.97
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.79 / $162.18 / $213.80	Professional		$0.79	$162.18	$213.80
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.36 / $48.98 / $66.07	Professional	26	$0.36	$48.98	$66.07
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $120.23 / $158.49	Professional	TC	$72.44	$120.23	$158.49
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.79 / $0.79 / $199.53	Professional		$0.79	$0.79	$199.53
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.36 / $0.36 / $61.66	Professional	26	$0.36	$0.36	$61.66
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $138.04 / $144.54	Professional	TC	$138.04	$138.04	$144.54
Select Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $134.90 / $134.90	Professional		$131.83	$134.90	$134.90
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $41.69 / $41.69	Professional	26	$40.74	$41.69	$41.69
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $93.33 / $93.33	Professional	TC	$91.20	$93.33	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $141.25 / $218.78	Professional		$87.10	$141.25	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $43.65 / $67.61	Professional	26	$25.12	$43.65	$67.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $95.50 / $154.88	Professional	TC	$63.10	$95.50	$154.88