Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $75.86 / $91.20	Facility	26	$75.86	$75.86	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $338.84 / $1,412.54	Professional		$199.53	$338.84	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $89.13 / $158.49	Professional	26	$64.57	$89.13	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $194.98 / $371.54	Professional	TC	$131.83	$194.98	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $331.13	Professional		$169.82	$239.88	$331.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $58.88 / $67.61	Professional	26	$56.23	$58.88	$67.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $251.19 / $389.05	Professional		$218.78	$251.19	$389.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $79.43 / $125.89	Professional	26	$70.79	$79.43	$125.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $169.82 / $263.03	Professional	TC	$147.91	$169.82	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $281.84 / $426.58	Professional		$190.55	$281.84	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $87.10 / $134.90	Professional	26	$57.54	$87.10	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $186.21 / $281.84	Professional	TC	$125.89	$186.21	$281.84
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.45 / $257.04 / $346.74	Professional		$2.45	$257.04	$346.74
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $87.10 / $117.49	Professional	26	$0.63	$87.10	$117.49
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $186.21 / $239.88	Professional	TC	$107.15	$186.21	$239.88
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.45 / $2.45 / $323.59	Professional		$2.45	$2.45	$323.59
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $0.63 / $109.65	Professional	26	$0.63	$0.63	$109.65
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $204.17 / $213.80	Professional	TC	$204.17	$204.17	$213.80
Select Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $213.80	Professional		$213.80	$213.80	$213.80
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Professional	26	$72.44	$72.44	$72.44
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $144.54 / $144.54	Professional	TC	$141.25	$144.54	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $398.11 / $1,122.02	Professional		$213.80	$398.11	$1,122.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $70.79 / $134.90	Professional	26	$58.88	$70.79	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $288.40 / $1,047.13	Professional	TC	$138.04	$288.40	$1,047.13