Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $97.72 / $218.78	Professional		$63.10	$97.72	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $44.67 / $117.49	Professional	26	$26.92	$44.67	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $64.57 / $104.71	Professional	TC	$43.65	$64.57	$104.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $63.10 / $131.83	Professional		$54.95	$63.10	$131.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.22 / $102.33	Professional	26	$16.22	$16.22	$102.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $44.67	Professional	TC	$44.67	$44.67	$44.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $53.70 / $100.00	Professional		$44.67	$53.70	$100.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.98 / $61.66	Professional	26	$16.22	$16.98	$61.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $29.51 / $42.66	Professional	TC	$29.51	$29.51	$42.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $74.13 / $138.04	Facility		$69.18	$74.13	$138.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $24.55 / $45.71	Facility	26	$22.91	$24.55	$45.71
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $46.77 / $48.98 / $91.20	Facility	TC	$46.77	$48.98	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $66.07 / $190.55	Professional		$51.29	$66.07	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $25.12 / $56.23	Professional	26	$16.22	$25.12	$56.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $38.02 / $131.83	Professional	TC	$33.88	$38.02	$131.83
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $144.54 / $177.83	Professional		$26.92	$144.54	$177.83
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $42.66 / $53.70	Professional	26	$9.77	$42.66	$53.70
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $100.00 / $125.89	Professional	TC	$17.38	$100.00	$125.89
Select Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $109.65 / $165.96	Professional		$102.33	$109.65	$165.96
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $32.36 / $58.88	Professional	26	$31.62	$32.36	$58.88
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $77.62 / $107.15	Professional	TC	$70.79	$77.62	$107.15
United Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $35.48 / $69.18	Facility		$18.62	$35.48	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $64.57 / $169.82	Professional		$53.70	$64.57	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $24.55 / $61.66	Professional	26	$19.95	$24.55	$61.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $42.66 / $112.20	Professional	TC	$34.67	$42.66	$112.20