Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $416.87 / $416.87 / $501.19	Facility	26	$416.87	$416.87	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $2,238.72 / $10,715.19	Professional		$1,737.80	$2,238.72	$10,715.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $371.54 / $501.19 / $2,041.74	Professional	26	$371.54	$501.19	$2,041.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,318.26 / $1,737.80 / $8,317.64	Professional	TC	$1,318.26	$1,737.80	$8,317.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,445.44 / $2,089.30	Professional		$1,380.38	$1,445.44	$2,089.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $323.59 / $363.08 / $524.81	Professional	26	$323.59	$363.08	$524.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,698.24 / $1,819.70 / $3,162.28	Professional		$1,698.24	$1,819.70	$3,162.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $389.05 / $389.05 / $776.25	Professional	26	$389.05	$389.05	$776.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,318.26 / $1,479.11 / $2,344.23	Professional	TC	$1,318.26	$1,479.11	$2,344.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,187.76 / $3,548.13	Professional		$1,659.59	$2,187.76	$3,548.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $338.84 / $478.63 / $812.83	Professional	26	$338.84	$478.63	$812.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,230.27 / $1,737.80 / $2,754.23	Professional	TC	$1,230.27	$1,737.80	$2,754.23
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $2,344.23 / $3,311.31	Professional		$11.48	$2,344.23	$3,311.31
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.31 / $501.19 / $707.95	Professional	26	$3.31	$501.19	$707.95
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $707.95 / $1,862.09 / $2,570.40	Professional	TC	$707.95	$1,862.09	$2,570.40
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $11.48 / $2,951.21	Professional		$11.48	$11.48	$2,951.21
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.31 / $3.31 / $630.96	Professional	26	$3.31	$3.31	$630.96
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,174.90 / $1,174.90 / $2,344.23	Professional	TC	$1,174.90	$1,174.90	$2,344.23
Select Health Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $1,949.84 / $1,949.84	Professional		$1,778.28	$1,949.84	$1,949.84
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $407.38 / $416.87 / $416.87	Professional	26	$407.38	$416.87	$416.87
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,380.38 / $1,548.82 / $1,548.82	Professional	TC	$1,380.38	$1,548.82	$1,548.82
United Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $2,454.71 / $3,630.78	Professional		$1,513.56	$2,454.71	$3,630.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $281.84 / $524.81 / $794.33	Professional	26	$281.84	$524.81	$794.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,230.27 / $1,949.84 / $2,884.03	Professional	TC	$1,230.27	$1,949.84	$2,884.03