Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $21.12 / $25.34	Facility	26	$19.95	$21.12	$25.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.02 / $67.64 / $365.16	Professional		$63.02	$67.64	$365.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.57 / $21.62 / $125.87	Professional	26	$19.57	$21.62	$125.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.42 / $46.02 / $239.29	Professional	TC	$43.42	$46.02	$239.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.58 / $66.95 / $87.21	Professional		$59.58	$66.95	$87.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.68 / $23.99 / $29.20	Professional	26	$19.68	$23.99	$29.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.35 / $46.40 / $58.10	Professional	TC	$38.35	$46.40	$58.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.47 / $81.31 / $122.26	Professional		$54.47	$81.31	$122.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.34 / $25.85 / $39.19	Professional	26	$17.34	$25.85	$39.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.86 / $53.56 / $83.07	Professional	TC	$36.86	$53.56	$83.07
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.54 / $84.01 / $107.92	Professional		$0.54	$84.01	$107.92
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.25 / $25.69 / $33.50	Professional	26	$0.25	$25.69	$33.50
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.28 / $57.30 / $73.61	Professional	TC	$0.28	$57.30	$73.61
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.54 / $63.25 / $96.93	Professional		$0.54	$63.25	$96.93
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.25 / $20.55 / $30.83	Professional	26	$0.25	$20.55	$30.83
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.28 / $44.08 / $66.12	Professional	TC	$0.28	$44.08	$66.12
United Facility/Professional Professional Modifier Low / Median / High Price $50.58 / $64.23 / $112.14	Professional		$50.58	$64.23	$112.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.48 / $22.74 / $41.76	Professional	26	$16.48	$22.74	$41.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.10 / $41.54 / $76.40	Professional	TC	$34.10	$41.54	$76.40