Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $223.87 / $537.03	Professional		$89.13	$223.87	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $51.29 / $204.17	Professional	26	$25.70	$51.29	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $117.49 / $204.17	Professional	TC	$57.54	$117.49	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $104.71 / $239.88	Professional		$56.23	$104.71	$239.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $23.99 / $114.82	Professional	26	$16.22	$23.99	$114.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $81.28 / $218.78	Professional	TC	$40.74	$81.28	$218.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.39 / $23.44 / $43.65	Facility	26	$22.39	$23.44	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $138.04 / $181.97	Professional		$52.48	$138.04	$181.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $37.15 / $53.70	Professional	26	$15.49	$37.15	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $107.15 / $128.82	Professional	TC	$37.15	$107.15	$128.82
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $138.04 / $169.82	Professional		$61.66	$138.04	$169.82
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $40.74 / $50.12	Professional	26	$13.80	$40.74	$50.12
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $95.50 / $120.23	Professional	TC	$46.77	$95.50	$120.23
Select Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $104.71 / $190.55	Professional		$97.72	$104.71	$190.55
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $30.90 / $57.54	Professional	26	$30.20	$30.90	$57.54
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $74.13 / $131.83	Professional	TC	$67.61	$74.13	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $114.82 / $213.80	Professional		$69.18	$114.82	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $35.48 / $72.44	Professional	26	$21.38	$35.48	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $79.43 / $138.04	Professional	TC	$47.86	$79.43	$138.04