Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.23 / $83.94 / $100.73	Facility	26	$66.23	$83.94	$100.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.21 / $170.83 / $756.00	Professional		$147.21	$170.83	$756.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.54 / $83.94 / $307.00	Professional	26	$52.54	$83.94	$307.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.84 / $99.40 / $192.00	Professional	TC	$68.84	$99.40	$192.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.53 / $102.66 / $144.32	Professional	26	$53.53	$102.66	$144.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.66 / $134.93 / $185.04	Professional		$90.66	$134.93	$185.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.82 / $65.72 / $84.71	Professional	26	$42.82	$65.72	$84.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.84 / $69.20 / $104.14	Professional	TC	$47.84	$69.20	$104.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.86 / $215.40 / $351.81	Professional		$122.86	$215.40	$351.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.32 / $70.36 / $116.78	Professional	26	$45.32	$70.36	$116.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.52 / $113.10 / $280.07	Professional	TC	$69.52	$113.10	$280.07
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.06 / $153.04 / $214.25	Professional		$3.06	$153.04	$214.25
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $76.65 / $112.53	Professional	26	$0.63	$76.65	$112.53
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.43 / $74.26 / $97.71	Professional	TC	$2.43	$74.26	$97.71
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.06 / $122.43 / $183.65	Professional		$3.06	$122.43	$183.65
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $66.65 / $99.98	Professional	26	$0.63	$66.65	$99.98
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.43 / $55.78 / $83.67	Professional	TC	$2.43	$55.78	$83.67
United Facility/Professional Professional Modifier Low / Median / High Price $122.13 / $166.57 / $318.61	Professional		$122.13	$166.57	$318.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.78 / $64.42 / $111.73	Professional	26	$41.78	$64.42	$111.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.21 / $77.95 / $225.69	Professional	TC	$62.21	$77.95	$225.69