Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $57.54 / $95.50	Professional		$47.86	$57.54	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $21.88 / $28.84	Professional	26	$19.05	$21.88	$28.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $34.67 / $69.18	Professional	TC	$26.92	$34.67	$69.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $40.74 / $47.86	Professional		$26.92	$40.74	$47.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $12.30 / $30.90	Professional	26	$10.47	$12.30	$30.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $16.60 / $33.88	Professional	TC	$16.60	$16.60	$33.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $17.78 / $33.11	Facility	26	$16.60	$17.78	$33.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $40.74 / $134.90	Professional		$29.51	$40.74	$134.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.45 / $38.90	Professional	26	$12.02	$14.45	$38.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $28.84 / $91.20	Professional	TC	$17.78	$28.84	$91.20
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $107.15 / $134.90	Professional		$14.13	$107.15	$134.90
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $30.90 / $38.90	Professional	26	$5.62	$30.90	$38.90
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $8.51 / $75.86 / $95.50	Professional	TC	$8.51	$75.86	$95.50
Select Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $83.18 / $125.89	Professional		$77.62	$83.18	$125.89
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $23.99 / $43.65	Professional	26	$23.44	$23.99	$43.65
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $58.88 / $83.18	Professional	TC	$53.70	$58.88	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $41.69 / $104.71	Professional		$22.91	$41.69	$104.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $15.85 / $41.69	Professional	26	$14.45	$15.85	$41.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.70 / $69.18	Professional	TC	$19.05	$25.70	$69.18