Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.73 / $104.35 / $125.22	Facility	26	$94.73	$104.35	$125.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $960.47 / $1,003.12 / $4,963.22	Professional		$960.47	$1,003.12	$4,963.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $858.76 / $898.77 / $4,394.97	Professional	TC	$858.76	$898.77	$4,394.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $775.35 / $829.49 / $1,159.47	Professional		$775.35	$829.49	$1,159.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $671.59 / $717.93 / $1,043.25	Professional	TC	$671.59	$717.93	$1,043.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $300.94 / $931.03 / $1,820.41	Professional		$300.94	$931.03	$1,820.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.01 / $843.81 / $1,630.95	Professional	TC	$186.01	$843.81	$1,630.95
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.11 / $1,288.20 / $1,813.00	Professional		$2.11	$1,288.20	$1,813.00
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.05 / $122.76 / $178.92	Professional	26	$1.05	$122.76	$178.92
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.10 / $998.95 / $1,559.38	Professional	TC	$2.10	$998.95	$1,559.38
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.11 / $910.20 / $1,554.00	Professional		$2.11	$910.20	$1,554.00
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.05 / $606.21 / $1,400.64	Professional	TC	$1.05	$606.21	$1,400.64
United Facility/Professional Professional Modifier Low / Median / High Price $302.47 / $993.33 / $1,590.57	Professional		$302.47	$993.33	$1,590.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $318.87 / $861.78 / $1,406.09	Professional	TC	$318.87	$861.78	$1,406.09