Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $47.86 / $57.54	Facility	26	$47.86	$47.86	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $181.97 / $794.33	Professional		$134.90	$181.97	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $52.48 / $199.53	Professional	26	$39.81	$52.48	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $123.03 / $309.03	Professional	TC	$95.50	$123.03	$309.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $125.89 / $199.53	Professional		$102.33	$125.89	$199.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $38.02 / $75.86	Professional	26	$34.67	$38.02	$75.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $91.20 / $93.33	Professional	TC	$83.18	$91.20	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $151.36 / $263.03	Professional		$147.91	$151.36	$263.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $44.67 / $75.86	Professional	26	$41.69	$44.67	$75.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $107.15 / $181.97	Professional	TC	$104.71	$107.15	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $186.21 / $302.00	Professional		$131.83	$186.21	$302.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $54.95 / $87.10	Professional	26	$38.90	$54.95	$87.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $131.83 / $208.93	Professional	TC	$95.50	$131.83	$208.93
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $204.17 / $263.03	Professional		$154.88	$204.17	$263.03
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $60.26 / $75.86	Professional	26	$44.67	$60.26	$75.86
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $144.54 / $186.21	Professional	TC	$109.65	$144.54	$186.21
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Professional		$234.42	$234.42	$234.42
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $69.18 / $69.18	Professional	26	$69.18	$69.18	$69.18
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $165.96 / $165.96	Professional	TC	$165.96	$165.96	$165.96
Select Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $45.71 / $45.71	Professional	26	$44.67	$45.71	$45.71
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $109.65 / $109.65	Professional	TC	$107.15	$109.65	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $190.55 / $281.84	Professional		$134.90	$190.55	$281.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $56.23 / $83.18	Professional	26	$38.90	$56.23	$83.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $131.83 / $199.53	Professional	TC	$95.50	$131.83	$199.53