Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.66 / $348.84 / $613.71	Professional		$143.66	$348.84	$613.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.84 / $101.53 / $242.43	Professional	26	$72.84	$101.53	$242.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.81 / $94.04 / $204.12	Professional	TC	$70.81	$94.04	$204.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.06 / $109.06 / $384.40	Professional		$109.06	$109.06	$384.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.84 / $51.84 / $214.30	Professional	26	$51.84	$51.84	$214.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.27 / $58.27 / $170.10	Professional	TC	$58.27	$58.27	$170.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.54 / $90.94 / $168.42	Facility	26	$85.54	$90.94	$168.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.30 / $141.78 / $395.73	Professional		$117.30	$141.78	$395.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.59 / $68.55 / $214.23	Professional	26	$64.59	$68.55	$214.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.26 / $77.18 / $199.80	Professional	TC	$58.26	$77.18	$199.80
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $64.98 / $235.05 / $373.85	Professional		$64.98	$235.05	$373.85
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.30 / $118.16 / $187.93	Professional	26	$29.30	$118.16	$187.93
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.69 / $116.90 / $185.92	Professional	TC	$35.69	$116.90	$185.92
United Facility/Professional Professional Modifier Low / Median / High Price $140.13 / $172.28 / $384.58	Professional		$140.13	$172.28	$384.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.18 / $80.72 / $214.23	Professional	26	$76.18	$80.72	$214.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.88 / $87.40 / $170.35	Professional	TC	$63.88	$87.40	$170.35