Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $269.15 / $338.84	Facility		$117.49	$269.15	$338.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $26.92 / $33.11	Facility	26	$26.92	$26.92	$33.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $128.82 / $501.19	Professional		$77.62	$128.82	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $34.67 / $154.88	Professional	26	$23.99	$34.67	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $91.20 / $389.05	Professional	TC	$52.48	$91.20	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $85.11 / $97.72	Professional		$74.13	$85.11	$97.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $21.38 / $33.11	Professional	26	$19.50	$21.38	$33.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $158.49 / $158.49	Facility		$100.00	$158.49	$158.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $109.65 / $165.96	Professional		$61.66	$109.65	$165.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $25.12 / $43.65	Professional	26	$23.44	$25.12	$43.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $85.11 / $123.03	Professional	TC	$38.02	$85.11	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $97.72 / $181.97	Professional		$63.10	$97.72	$181.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $28.84 / $43.65	Professional	26	$20.42	$28.84	$43.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $67.61 / $141.25	Professional	TC	$41.69	$67.61	$141.25
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.52 / $120.23 / $204.17	Professional		$0.52	$120.23	$204.17
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.18 / $26.92 / $45.71	Professional	26	$0.18	$26.92	$45.71
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.34 / $93.33 / $158.49	Professional	TC	$0.34	$93.33	$158.49
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.52 / $0.52 / $181.97	Professional		$0.52	$0.52	$181.97
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.18 / $0.18 / $40.74	Professional	26	$0.18	$0.18	$40.74
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.34 / $0.34 / $141.25	Professional	TC	$0.34	$0.34	$141.25
Select Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $120.23 / $120.23	Professional		$109.65	$120.23	$120.23
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $26.92 / $26.92	Professional	26	$25.12	$26.92	$26.92
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $93.33 / $93.33	Professional	TC	$85.11	$93.33	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $109.65 / $144.54	Professional		$54.95	$109.65	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $28.18 / $41.69	Professional	26	$18.62	$28.18	$41.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $81.28 / $107.15	Professional	TC	$35.48	$81.28	$107.15