Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $91.20 / $165.96	Professional		$79.43	$91.20	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $70.79 / $478.63	Professional	26	$54.95	$70.79	$478.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $33.88 / $66.07	Professional	TC	$28.84	$33.88	$66.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Professional		$48.98	$48.98	$48.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $28.84 / $181.97	Professional	26	$28.84	$28.84	$181.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $51.29 / $117.49	Professional		$39.81	$51.29	$117.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $30.20 / $87.10	Professional	26	$26.92	$30.20	$87.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $20.89 / $30.90	Professional	TC	$13.49	$20.89	$30.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $72.44 / $134.90	Facility		$69.18	$72.44	$134.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $43.65 / $81.28	Facility	26	$40.74	$43.65	$81.28
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.54 / $29.51 / $54.95	Facility	TC	$27.54	$29.51	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $57.54 / $169.82	Professional		$47.86	$57.54	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $36.31 / $100.00	Professional	26	$28.84	$36.31	$100.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $21.38 / $69.18	Professional	TC	$17.78	$21.38	$69.18
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $125.89 / $158.49	Professional		$23.44	$125.89	$158.49
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $75.86 / $93.33	Professional	26	$14.13	$75.86	$93.33
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $9.12 / $51.29 / $64.57	Professional	TC	$9.12	$51.29	$64.57
Select Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $97.72 / $173.78	Professional		$91.20	$97.72	$173.78
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $57.54 / $104.71	Professional	26	$56.23	$57.54	$104.71
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $39.81 / $66.07	Professional	TC	$36.31	$39.81	$66.07
United Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $33.11 / $70.79	Facility		$12.02	$33.11	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $63.10 / $131.83	Professional		$54.95	$63.10	$131.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $38.90 / $104.71	Professional	26	$35.48	$38.90	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $21.88 / $67.61	Professional	TC	$19.05	$21.88	$67.61