Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $87.10	Facility	26	$72.44	$72.44	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $269.15 / $549.54	Professional		$199.53	$269.15	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $67.61 / $104.71	Professional	26	$52.48	$67.61	$104.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $194.98 / $457.09	Professional	TC	$147.91	$194.98	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $45.71 / $45.71	Professional	26	$45.71	$45.71	$45.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $263.03 / $457.09	Professional		$213.80	$263.03	$457.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $57.54 / $120.23	Professional	26	$39.81	$57.54	$120.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $194.98 / $416.87	Professional	TC	$158.49	$194.98	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $467.74 / $812.83	Professional		$251.19	$467.74	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $70.79 / $117.49	Professional	26	$51.29	$70.79	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $354.81 / $691.83	Professional	TC	$181.97	$354.81	$691.83
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.09 / $263.03 / $389.05	Professional		$3.09	$263.03	$389.05
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $72.44 / $100.00	Professional	26	$0.63	$72.44	$100.00
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.45 / $194.98 / $281.84	Professional	TC	$2.45	$194.98	$281.84
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.09 / $3.09 / $331.13	Professional		$3.09	$3.09	$331.13
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $0.63 / $89.13	Professional	26	$0.63	$0.63	$89.13
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.45 / $2.45 / $239.88	Professional	TC	$2.45	$2.45	$239.88
Select Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $218.78 / $218.78	Professional		$208.93	$218.78	$218.78
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $60.26 / $60.26	Professional	26	$58.88	$60.26	$60.26
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $162.18 / $162.18	Professional	TC	$151.36	$162.18	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $295.12 / $758.58	Professional		$199.53	$295.12	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $64.57 / $120.23	Professional	26	$43.65	$64.57	$120.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $288.40 / $691.83	Professional	TC	$138.04	$288.40	$691.83