Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $97.72 / $117.49	Facility	26	$97.72	$97.72	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $288.40 / $676.08	Professional		$223.87	$288.40	$676.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $89.13 / $338.84	Professional	26	$69.18	$89.13	$338.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $190.55 / $302.00	Professional	TC	$147.91	$190.55	$302.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $64.57 / $138.04	Professional	26	$60.26	$64.57	$138.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $263.03 / $398.11	Professional		$223.87	$263.03	$398.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $77.62 / $138.04	Professional	26	$74.13	$77.62	$138.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $177.83 / $257.04	Professional	TC	$144.54	$177.83	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $281.84 / $436.52	Professional		$199.53	$281.84	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $95.50 / $141.25	Professional	26	$61.66	$95.50	$141.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $194.98 / $288.40	Professional	TC	$125.89	$194.98	$288.40
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.09 / $295.12 / $389.05	Professional		$3.09	$295.12	$389.05
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.81 / $95.50 / $128.82	Professional	26	$0.81	$95.50	$128.82
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $194.98 / $263.03	Professional	TC	$117.49	$194.98	$263.03
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.09 / $3.09 / $346.74	Professional		$3.09	$3.09	$346.74
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.81 / $0.81 / $120.23	Professional	26	$0.81	$0.81	$120.23
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $223.87 / $234.42	Professional	TC	$223.87	$223.87	$234.42
Select Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $229.09 / $229.09	Professional		$223.87	$229.09	$229.09
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $79.43 / $79.43	Professional	26	$79.43	$79.43	$79.43
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $147.91 / $147.91	Professional	TC	$144.54	$147.91	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $251.19 / $426.58	Professional		$213.80	$251.19	$426.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $75.86 / $144.54	Professional	26	$66.07	$75.86	$144.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $173.78 / $302.00	Professional	TC	$138.04	$173.78	$302.00