Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.47 / $42.47 / $47.57	Facility	26	$42.47	$42.47	$47.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.07 / $154.36 / $267.42	Professional		$128.07	$154.36	$267.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.99 / $47.57 / $186.78	Professional	26	$39.99	$47.57	$186.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.60 / $96.91 / $219.44	Professional	TC	$85.60	$96.91	$219.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.89 / $117.16 / $204.57	Professional		$104.89	$117.16	$204.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.24 / $39.63 / $68.97	Professional	26	$33.24	$39.63	$68.97
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $136.43 / $168.91 / $258.18	Professional	50	$136.43	$168.91	$258.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.38 / $79.06 / $136.04	Professional	TC	$70.38	$79.06	$136.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.64 / $155.56 / $230.67	Professional		$107.64	$155.56	$230.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.47 / $53.99 / $76.45	Professional	26	$37.47	$53.99	$76.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.06 / $92.92 / $155.97	Professional	TC	$57.06	$92.92	$155.97
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.03 / $178.59 / $259.76	Professional		$1.03	$178.59	$259.76
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.60 / $54.22 / $69.66	Professional	26	$0.60	$54.22	$69.66
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.43 / $126.67 / $193.02	Professional	TC	$0.43	$126.67	$193.02
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.03 / $152.57 / $243.53	Professional		$1.03	$152.57	$243.53
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.60 / $41.71 / $62.57	Professional	26	$0.60	$41.71	$62.57
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.43 / $120.64 / $180.96	Professional	TC	$0.43	$120.64	$180.96
United Facility/Professional Professional Modifier Low / Median / High Price $104.82 / $142.63 / $202.64	Professional		$104.82	$142.63	$202.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.65 / $53.06 / $81.45	Professional	26	$36.65	$53.06	$81.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.56 / $95.48 / $138.16	Professional	TC	$61.56	$95.48	$138.16