Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $36.31 / $43.65	Facility	26	$36.31	$36.31	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $158.49 / $524.81	Professional		$123.03	$158.49	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.02 / $165.96	Professional	26	$28.18	$38.02	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $117.49 / $213.80	Professional	TC	$93.33	$117.49	$213.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $26.30 / $26.30	Professional	26	$26.30	$26.30	$26.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $141.25 / $245.47	Professional		$138.04	$141.25	$245.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $36.31 / $58.88	Professional	26	$33.88	$36.31	$58.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $109.65 / $190.55	Professional	TC	$100.00	$109.65	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $181.97 / $288.40	Professional		$128.82	$181.97	$288.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $44.67 / $69.18	Professional	26	$30.20	$44.67	$69.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $138.04 / $213.80	Professional	TC	$93.33	$138.04	$213.80
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.68 / $169.82 / $239.88	Professional		$0.68	$169.82	$239.88
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.27 / $39.81 / $58.88	Professional	26	$0.27	$39.81	$58.88
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $125.89 / $177.83	Professional	TC	$53.70	$125.89	$177.83
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.68 / $0.68 / $213.80	Professional		$0.68	$0.68	$213.80
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.27 / $0.27 / $51.29	Professional	26	$0.27	$0.27	$51.29
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $89.13 / $162.18	Professional	TC	$89.13	$89.13	$162.18
Select Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $144.54 / $199.53	Professional		$141.25	$144.54	$199.53
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $34.67 / $51.29	Professional	26	$34.67	$34.67	$51.29
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $109.65 / $151.36	Professional	TC	$107.15	$109.65	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $158.49 / $234.42	Professional		$102.33	$158.49	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $38.90 / $58.88	Professional	26	$27.54	$38.90	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $120.23 / $173.78	Professional	TC	$75.86	$120.23	$173.78