Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $75.86 / $91.20	Facility	26	$75.86	$75.86	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $537.03 / $2,570.40	Professional		$416.87	$537.03	$2,570.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $83.18 / $346.74	Professional	26	$70.79	$83.18	$346.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $416.87 / $1,995.26	Professional	TC	$346.74	$416.87	$1,995.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $331.13 / $489.78	Professional		$275.42	$331.13	$489.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $69.18 / $123.03	Professional	26	$56.23	$69.18	$123.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $234.42 / $281.84	Professional	TC	$234.42	$234.42	$281.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $741.31	Professional		$426.58	$426.58	$741.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $70.79 / $123.03	Professional	26	$70.79	$70.79	$123.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $354.81 / $616.60	Professional	TC	$354.81	$354.81	$616.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $724.44 / $812.83	Professional		$426.58	$724.44	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $123.03 / $144.54	Professional	26	$70.79	$123.03	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $602.56 / $676.08	Professional	TC	$363.08	$602.56	$676.08
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.80 / $575.44 / $741.31	Professional		$3.80	$575.44	$741.31
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.74 / $100.00 / $128.82	Professional	26	$0.74	$100.00	$128.82
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $524.81 / $676.08	Professional	TC	$338.84	$524.81	$676.08
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.80 / $3.80 / $645.65	Professional		$3.80	$3.80	$645.65
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.74 / $0.74 / $112.20	Professional	26	$0.74	$0.74	$112.20
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $524.81 / $1,122.02	Professional	TC	$524.81	$524.81	$1,122.02
Select Health Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $426.58	Professional		$426.58	$426.58	$426.58
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Professional	26	$74.13	$74.13	$74.13
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $354.81 / $354.81	Professional	TC	$354.81	$354.81	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $524.81 / $912.01	Professional		$316.23	$524.81	$912.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $89.13 / $154.88	Professional	26	$67.61	$89.13	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $426.58 / $758.58	Professional	TC	$346.74	$426.58	$758.58