Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $104.71 / $125.89	Facility	26	$104.71	$104.71	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $446.68 / $758.58	Professional		$389.05	$446.68	$758.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $112.20 / $457.09	Professional	26	$93.33	$112.20	$457.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $323.59 / $562.34	Professional	TC	$295.12	$323.59	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $295.12 / $398.11	Professional		$269.15	$295.12	$398.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $89.13 / $107.15	Professional	26	$81.28	$89.13	$107.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $416.87 / $831.76	Professional		$389.05	$416.87	$831.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $97.72 / $194.98	Professional	26	$97.72	$97.72	$194.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $323.59 / $630.96	Professional	TC	$295.12	$323.59	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $512.86 / $776.25	Professional		$398.11	$512.86	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $123.03 / $204.17	Professional	26	$91.20	$123.03	$204.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $389.05 / $575.44	Professional	TC	$302.00	$389.05	$575.44
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $549.54 / $691.83	Professional		$407.38	$549.54	$691.83
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $141.25 / $177.83	Professional	26	$95.50	$141.25	$177.83
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $407.38 / $512.86	Professional	TC	$309.03	$407.38	$512.86
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $602.56	Professional		$602.56	$602.56	$602.56
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $158.49 / $158.49	Professional	26	$158.49	$158.49	$158.49
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $446.68 / $446.68	Professional	TC	$446.68	$446.68	$446.68
Select Health Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $398.11 / $398.11	Professional		$389.05	$398.11	$398.11
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $104.71 / $104.71	Professional	26	$102.33	$104.71	$104.71
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $295.12 / $295.12	Professional	TC	$288.40	$295.12	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $575.44 / $851.14	Professional		$363.08	$575.44	$851.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $138.04 / $204.17	Professional	26	$83.18	$138.04	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $436.52 / $645.65	Professional	TC	$263.03	$436.52	$645.65