Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.11 / $97.76 / $117.31	Facility	26	$92.11	$97.76	$117.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $827.08 / $1,099.28 / $5,496.30	Professional		$827.08	$1,099.28	$5,496.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.76 / $107.83 / $578.66	Professional	26	$97.76	$107.83	$578.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $727.23 / $778.28 / $4,917.58	Professional	TC	$727.23	$778.28	$4,917.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $826.13 / $1,297.19 / $1,433.18	Professional		$826.13	$1,297.19	$1,433.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.12 / $130.85 / $158.07	Professional	26	$91.12	$130.85	$158.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $735.01 / $1,166.33 / $1,275.09	Professional	TC	$735.01	$1,166.33	$1,275.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $760.38 / $1,309.54 / $1,625.63	Professional		$760.38	$1,309.54	$1,625.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.63 / $146.13 / $184.21	Professional	26	$80.63	$146.13	$184.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $679.75 / $1,163.40 / $1,444.23	Professional	TC	$679.75	$1,163.40	$1,444.23
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $712.18 / $1,068.27 / $1,321.49	Professional		$712.18	$1,068.27	$1,321.49
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $84.04 / $126.06 / $155.94	Professional	26	$84.04	$126.06	$155.94
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $663.04 / $901.66 / $1,165.56	Professional	TC	$663.04	$901.66	$1,165.56
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $776.28 / $776.28 / $1,186.97	Professional		$776.28	$776.28	$1,186.97
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.38 / $140.07 / $140.07	Professional	26	$93.38	$140.07	$140.07
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $697.94 / $1,046.91 / $1,229.54	Professional	TC	$697.94	$1,046.91	$1,229.54
United Facility/Professional Professional Modifier Low / Median / High Price $805.89 / $985.04 / $1,754.91	Professional		$805.89	$985.04	$1,754.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.26 / $128.33 / $197.20	Professional	26	$88.26	$128.33	$197.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $670.14 / $844.27 / $1,562.72	Professional	TC	$670.14	$844.27	$1,562.72