Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $58.88 / $72.44	Facility	26	$58.88	$58.88	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $165.96 / $1,479.11	Professional		$117.49	$165.96	$1,479.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $173.78 / $954.99	Professional	26	$58.88	$173.78	$954.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $87.10 / $389.05	Professional	TC	$63.10	$87.10	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $97.72 / $147.91	Professional		$93.33	$97.72	$147.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $48.98 / $67.61	Professional	26	$44.67	$48.98	$67.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $134.90 / $245.47	Professional		$114.82	$134.90	$245.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $56.23 / $112.20	Professional	26	$56.23	$56.23	$112.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $74.13 / $128.82	Professional	TC	$60.26	$74.13	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $186.21 / $251.19	Professional		$128.82	$186.21	$251.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $75.86 / $117.49	Professional	26	$53.70	$75.86	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $109.65 / $147.91	Professional	TC	$74.13	$109.65	$147.91
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.41 / $151.36 / $223.87	Professional		$1.41	$151.36	$223.87
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.65 / $72.44 / $100.00	Professional	26	$0.65	$72.44	$100.00
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $87.10 / $117.49	Professional	TC	$63.10	$87.10	$117.49
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.41 / $1.41 / $190.55	Professional		$1.41	$1.41	$190.55
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.65 / $0.65 / $91.20	Professional	26	$0.65	$0.65	$91.20
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $100.00 / $104.71	Professional	TC	$100.00	$100.00	$104.71
Select Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $125.89 / $125.89	Professional		$123.03	$125.89	$125.89
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $60.26 / $60.26	Professional	26	$58.88	$60.26	$60.26
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $66.07 / $66.07	Professional	TC	$64.57	$66.07	$66.07
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $190.55 / $245.47	Professional		$128.82	$190.55	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $77.62 / $117.49	Professional	26	$43.65	$77.62	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $109.65 / $144.54	Professional	TC	$67.61	$109.65	$144.54