Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.32 / $40.06 / $50.60	Facility	26	$34.32	$40.06	$50.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.02 / $164.74 / $314.82	Professional		$143.02	$164.74	$314.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.32 / $52.49 / $102.85	Professional	26	$34.32	$52.49	$102.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.30 / $112.25 / $250.03	Professional	TC	$82.30	$112.25	$250.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.57 / $95.57 / $95.57	Professional		$95.57	$95.57	$95.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $165.32 / $165.32 / $165.32	Professional	26	$165.32	$165.32	$165.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.44 / $73.44 / $191.72	Professional		$73.44	$73.44	$191.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.60 / $22.60 / $69.05	Professional	26	$22.60	$22.60	$69.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.86 / $54.86 / $122.67	Professional	TC	$54.86	$54.86	$122.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.90 / $30.73 / $56.90	Facility	26	$28.90	$30.73	$56.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.45 / $91.68 / $293.89	Professional		$79.45	$91.68	$293.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.00 / $29.11 / $68.63	Professional	26	$22.00	$29.11	$68.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.34 / $69.68 / $225.26	Professional	TC	$50.34	$69.68	$225.26
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $46.71 / $177.43 / $282.20	Professional		$46.71	$177.43	$282.20
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.84 / $42.39 / $67.42	Professional	26	$14.84	$42.39	$67.42
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.87 / $135.04 / $214.78	Professional	TC	$31.87	$135.04	$214.78
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $46.71 / $168.70 / $253.47	Professional		$46.71	$168.70	$253.47
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.84 / $40.36 / $60.56	Professional	26	$14.84	$40.36	$60.56
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.87 / $128.61 / $192.92	Professional	TC	$31.87	$128.61	$192.92
United Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $110.44 / $230.08	Professional		$30.00	$110.44	$230.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.50 / $33.88 / $70.59	Professional	26	$27.50	$33.88	$70.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.44 / $82.94 / $172.79	Professional	TC	$53.44	$82.94	$172.79