Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $151.36 / $181.97	Facility	26	$151.36	$151.36	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $302.00 / $1,513.56	Professional		$257.04	$302.00	$1,513.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $162.18 / $794.33	Professional	26	$134.90	$162.18	$794.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $141.25 / $269.15	Professional	TC	$123.03	$141.25	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Professional		$309.03	$309.03	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $123.03 / $154.88	Professional	26	$123.03	$123.03	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $549.54	Professional		$263.03	$263.03	$549.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $141.25 / $281.84	Professional	26	$141.25	$141.25	$281.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $125.89 / $263.03	Professional	TC	$123.03	$125.89	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $338.84 / $562.34	Professional		$257.04	$338.84	$562.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $181.97 / $295.12	Professional	26	$131.83	$181.97	$295.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $162.18 / $269.15	Professional	TC	$125.89	$162.18	$269.15
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.07 / $346.74 / $489.78	Professional		$1.07	$346.74	$489.78
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.54 / $181.97 / $257.04	Professional	26	$0.54	$181.97	$257.04
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $177.83 / $245.47	Professional	TC	$104.71	$177.83	$245.47
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.07 / $1.07 / $436.52	Professional		$1.07	$1.07	$436.52
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.54 / $0.54 / $229.09	Professional	26	$0.54	$0.54	$229.09
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $208.93 / $218.78	Professional	TC	$208.93	$208.93	$218.78
Select Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $288.40 / $288.40	Professional		$281.84	$288.40	$288.40
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $151.36 / $151.36	Professional	26	$147.91	$151.36	$151.36
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $138.04 / $138.04	Professional	TC	$134.90	$138.04	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $371.54 / $549.54	Professional		$234.42	$371.54	$549.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $194.98 / $288.40	Professional	26	$120.23	$194.98	$288.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $173.78 / $257.04	Professional	TC	$107.15	$173.78	$257.04