Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.72 / $36.52 / $43.82	Facility	26	$34.72	$36.52	$43.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.28 / $250.21 / $587.60	Professional		$129.28	$250.21	$587.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.71 / $40.86 / $189.20	Professional	26	$32.71	$40.86	$189.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $40.02 / $564.00 / $762.00	Professional	52	$40.02	$564.00	$762.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.01 / $110.18 / $428.80	Professional	TC	$92.01	$110.18	$428.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.22 / $99.43 / $188.91	Professional		$95.22	$99.43	$188.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.79 / $34.52 / $75.68	Professional	26	$27.79	$34.52	$75.68
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $83.57 / $83.57 / $83.57	Professional	52	$83.57	$83.57	$83.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.47 / $127.71 / $183.38	Professional		$106.47	$127.71	$183.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.40 / $33.33 / $49.17	Professional	26	$28.40	$33.33	$49.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.06 / $95.07 / $132.13	Professional	TC	$78.06	$95.07	$132.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.80 / $161.52 / $239.91	Professional		$108.80	$161.52	$239.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.24 / $45.93 / $67.76	Professional	26	$29.24	$45.93	$67.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.78 / $116.42 / $172.14	Professional	TC	$79.78	$116.42	$172.14
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $112.11 / $163.90 / $210.21	Professional		$112.11	$163.90	$210.21
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.42 / $48.11 / $154.15	Professional	26	$34.42	$48.11	$154.15
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.22 / $125.88 / $161.16	Professional	TC	$91.22	$125.88	$161.16
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $126.08 / $189.12 / $189.12	Professional		$126.08	$189.12	$189.12
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.86 / $52.29 / $52.29	Professional	26	$34.86	$52.29	$52.29
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.22 / $136.83 / $136.83	Professional	TC	$91.22	$136.83	$136.83
United Facility/Professional Professional Modifier Low / Median / High Price $111.23 / $153.24 / $253.55	Professional		$111.23	$153.24	$253.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.22 / $43.27 / $71.59	Professional	26	$30.22	$43.27	$71.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.98 / $109.97 / $181.95	Professional	TC	$79.98	$109.97	$181.95