Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $83.18 / $100.00	Facility	26	$83.18	$83.18	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $173.78 / $691.83	Professional		$131.83	$173.78	$691.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $83.18 / $302.00	Professional	26	$52.48	$83.18	$302.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $95.50 / $218.78	Professional	TC	$66.07	$95.50	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $95.50	Professional		$83.18	$83.18	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $54.95 / $114.82	Professional	26	$51.29	$54.95	$114.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $134.90 / $223.87	Professional		$120.23	$134.90	$223.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $66.07 / $107.15	Professional	26	$43.65	$66.07	$107.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $69.18 / $117.49	Professional	TC	$61.66	$69.18	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $204.17 / $371.54	Professional		$120.23	$204.17	$371.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $67.61 / $120.23	Professional	26	$47.86	$67.61	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $112.20 / $295.12	Professional	TC	$63.10	$112.20	$295.12
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.09 / $147.91 / $194.98	Professional		$3.09	$147.91	$194.98
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $75.86 / $107.15	Professional	26	$0.63	$75.86	$107.15
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.45 / $67.61 / $91.20	Professional	TC	$2.45	$67.61	$91.20
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.09 / $3.09 / $181.97	Professional		$3.09	$3.09	$181.97
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $0.63 / $100.00	Professional	26	$0.63	$0.63	$100.00
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.45 / $2.45 / $83.18	Professional	TC	$2.45	$2.45	$83.18
Select Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $144.54	Professional		$123.03	$123.03	$144.54
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $66.07 / $70.79	Professional	26	$66.07	$66.07	$70.79
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $56.23 / $72.44	Professional	TC	$54.95	$56.23	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $169.82 / $331.13	Professional		$112.20	$169.82	$331.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $64.57 / $97.72	Professional	26	$41.69	$64.57	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $85.11 / $239.88	Professional	TC	$57.54	$85.11	$239.88