Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.06 / $29.75 / $35.70	Facility	26	$29.06	$29.75	$35.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.49 / $70.52 / $145.99	Professional		$63.49	$70.52	$145.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.28 / $29.75 / $173.53	Professional	26	$26.28	$29.75	$173.53
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.71 / $33.40 / $193.05	Professional	52	$30.71	$33.40	$193.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.56 / $43.74 / $71.43	Professional	TC	$35.56	$43.74	$71.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.86 / $78.09 / $102.35	Professional		$62.86	$78.09	$102.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.94 / $31.02 / $41.87	Professional	26	$27.94	$31.02	$41.87
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $118.90 / $145.33 / $165.15	Professional	50	$118.90	$145.33	$165.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.92 / $47.07 / $60.73	Professional	TC	$34.92	$47.07	$60.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.68 / $88.23 / $131.77	Professional		$65.68	$88.23	$131.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.95 / $35.90 / $56.00	Professional	26	$24.95	$35.90	$56.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.14 / $52.21 / $80.09	Professional	TC	$37.14	$52.21	$80.09
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.61 / $83.29 / $124.94	Professional		$0.61	$83.29	$124.94
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.28 / $36.02 / $50.68	Professional	26	$0.28	$36.02	$50.68
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.32 / $50.53 / $70.92	Professional	TC	$0.32	$50.53	$70.92
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.61 / $65.89 / $104.12	Professional		$0.61	$65.89	$104.12
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.28 / $30.02 / $45.03	Professional	26	$0.28	$30.02	$45.03
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.32 / $39.40 / $59.10	Professional	TC	$0.32	$39.40	$59.10
United Facility/Professional Professional Modifier Low / Median / High Price $56.27 / $67.84 / $120.06	Professional		$56.27	$67.84	$120.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.63 / $31.76 / $51.92	Professional	26	$21.63	$31.76	$51.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.94 / $36.09 / $68.00	Professional	TC	$32.94	$36.09	$68.00