Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $22.91 / $27.54	Facility	26	$22.91	$22.91	$27.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $131.83 / $199.53	Professional		$100.00	$131.83	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $109.65 / $173.78	Professional	TC	$79.43	$109.65	$173.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $134.90 / $223.87	Professional		$112.20	$134.90	$223.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $114.82 / $173.78	Professional	TC	$87.10	$114.82	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $141.25 / $245.47	Professional		$95.50	$141.25	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $117.49 / $213.80	Professional	TC	$77.62	$117.49	$213.80
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.76 / $173.78 / $229.09	Professional		$0.76	$173.78	$229.09
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.27 / $27.54 / $36.31	Professional	26	$0.27	$27.54	$36.31
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $144.54 / $194.98	Professional	TC	$72.44	$144.54	$194.98
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.76 / $0.76 / $218.78	Professional		$0.76	$0.76	$218.78
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $151.36 / $181.97	Professional	TC	$151.36	$151.36	$181.97
Select Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $144.54 / $144.54	Professional		$134.90	$144.54	$144.54
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $120.23 / $120.23	Professional	TC	$112.20	$120.23	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $131.83 / $213.80	Professional		$83.18	$131.83	$213.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $107.15 / $173.78	Professional	TC	$66.07	$107.15	$173.78