Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $53.70 / $66.07	Facility	26	$53.70	$53.70	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $162.18 / $288.40	Professional		$120.23	$162.18	$288.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $52.48 / $131.83	Professional	26	$41.69	$52.48	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $102.33 / $218.78	Professional	TC	$75.86	$102.33	$218.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $36.31 / $37.15	Professional	26	$36.31	$36.31	$37.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $128.82 / $234.42	Professional		$117.49	$128.82	$234.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $45.71 / $75.86	Professional	26	$42.66	$45.71	$75.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $87.10 / $154.88	Professional	TC	$77.62	$87.10	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $199.53 / $302.00	Professional		$117.49	$199.53	$302.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $57.54 / $81.28	Professional	26	$34.67	$57.54	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $134.90 / $218.78	Professional	TC	$79.43	$134.90	$218.78
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.48 / $158.49 / $218.78	Professional		$1.48	$158.49	$218.78
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.43 / $53.70 / $70.79	Professional	26	$0.43	$53.70	$70.79
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.05 / $104.71 / $147.91	Professional	TC	$1.05	$104.71	$147.91
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.48 / $1.48 / $199.53	Professional		$1.48	$1.48	$199.53
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.43 / $0.43 / $66.07	Professional	26	$0.43	$0.43	$66.07
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.05 / $1.05 / $131.83	Professional	TC	$1.05	$1.05	$131.83
Select Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $131.83 / $131.83	Professional		$128.82	$131.83	$131.83
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $44.67 / $44.67	Professional	26	$42.66	$44.67	$44.67
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $87.10 / $87.10	Professional	TC	$85.11	$87.10	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $151.36 / $257.04	Professional		$117.49	$151.36	$257.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $42.66 / $79.43	Professional	26	$34.67	$42.66	$79.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $112.20 / $181.97	Professional	TC	$79.43	$112.20	$181.97