Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.86 / $198.64 / $336.94	Facility		$50.86	$198.64	$336.94
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.67 / $30.67 / $34.35	Facility	26	$30.67	$30.67	$34.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.83 / $80.08 / $334.86	Professional		$44.83	$80.08	$334.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.33 / $33.43 / $146.00	Professional	26	$28.33	$33.43	$146.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $209.18 / $326.11 / $334.86	Professional	50	$209.18	$326.11	$334.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $19.75 / $25.43 / $167.43	Professional	52	$19.75	$25.43	$167.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.66 / $32.86 / $85.60	Professional	TC	$15.66	$32.86	$85.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.33 / $70.01 / $91.75	Professional		$55.33	$70.01	$91.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.97 / $33.35 / $53.66	Professional	26	$25.97	$33.35	$53.66
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $92.23 / $108.51 / $126.73	Professional	50	$92.23	$108.51	$126.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.98 / $36.25 / $56.89	Professional	TC	$21.98	$36.25	$56.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.86 / $88.27 / $131.74	Professional		$50.86	$88.27	$131.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $36.82 / $55.20	Professional	26	$24.55	$36.82	$55.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.98 / $49.02 / $80.09	Professional	TC	$18.98	$49.02	$80.09
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.96 / $72.03 / $117.22	Professional		$0.96	$72.03	$117.22
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.35 / $34.52 / $50.68	Professional	26	$0.35	$34.52	$50.68
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.62 / $24.84 / $69.23	Professional	TC	$0.62	$24.84	$69.23
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $142.46 / $142.46 / $142.46	Facility		$142.46	$142.46	$142.46
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.96 / $45.51 / $72.03	Professional		$0.96	$45.51	$72.03
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.35 / $30.02 / $45.03	Professional	26	$0.35	$30.02	$45.03
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.62 / $18.00 / $27.00	Professional	TC	$0.62	$18.00	$27.00
United Facility/Professional Professional Modifier Low / Median / High Price $58.68 / $87.68 / $127.34	Professional		$58.68	$87.68	$127.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.98 / $36.24 / $58.96	Professional	26	$26.98	$36.24	$58.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.90 / $52.68 / $82.32	Professional	TC	$25.90	$52.68	$82.32