Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.55 / $33.47 / $40.18	Facility	26	$31.55	$33.47	$40.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.34 / $177.55 / $492.71	Professional		$113.34	$177.55	$492.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.75 / $45.47 / $172.84	Professional	26	$29.75	$45.47	$172.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $54.14 / $60.95 / $357.53	Professional	52	$54.14	$60.95	$357.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.82 / $97.52 / $219.00	Professional	TC	$82.82	$97.52	$219.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.14 / $95.70 / $214.94	Professional		$91.14	$95.70	$214.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.44 / $31.35 / $62.02	Professional	26	$24.44	$31.35	$62.02
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $21.90 / $21.90 / $43.29	Professional	52	$21.90	$21.90	$43.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.61 / $116.37 / $152.52	Professional		$114.61	$116.37	$152.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.11 / $33.17 / $43.47	Professional	26	$31.11	$33.17	$43.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.20 / $83.50 / $109.05	Professional	TC	$83.20	$83.50	$109.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.53 / $134.13 / $226.18	Professional		$87.53	$134.13	$226.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.57 / $42.61 / $62.13	Professional	26	$27.57	$42.61	$62.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.98 / $98.34 / $164.04	Professional	TC	$63.98	$98.34	$164.04
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.90 / $134.93 / $205.33	Professional		$0.90	$134.93	$205.33
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.39 / $38.61 / $54.33	Professional	26	$0.39	$38.61	$54.33
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.79 / $85.15 / $142.19	Professional	TC	$33.79	$85.15	$142.19
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.90 / $113.93 / $176.00	Professional		$0.90	$113.93	$176.00
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.39 / $32.18 / $48.27	Professional	26	$0.39	$32.18	$48.27
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.51 / $85.15 / $127.73	Professional	TC	$0.51	$85.15	$127.73
United Facility/Professional Professional Modifier Low / Median / High Price $85.26 / $125.23 / $229.97	Professional		$85.26	$125.23	$229.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.73 / $35.36 / $55.40	Professional	26	$24.73	$35.36	$55.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.53 / $89.86 / $165.02	Professional	TC	$60.53	$89.86	$165.02