Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $57.54 / $69.18	Facility	26	$57.54	$57.54	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $117.49 / $371.54	Professional		$83.18	$117.49	$371.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $70.79 / $257.04	Professional	26	$52.48	$70.79	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $43.65 / $81.28	Professional	TC	$25.70	$43.65	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $89.13 / $128.82	Professional		$87.10	$89.13	$128.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $52.48 / $58.88	Professional	26	$48.98	$52.48	$58.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $109.65 / $181.97	Professional		$85.11	$109.65	$181.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $63.10 / $102.33	Professional	26	$48.98	$63.10	$102.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $46.77 / $77.62	Professional	TC	$23.99	$46.77	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $104.71 / $177.83	Professional		$74.13	$104.71	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $66.07 / $104.71	Professional	26	$50.12	$66.07	$104.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $38.02 / $77.62	Professional	TC	$22.91	$38.02	$77.62
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.69 / $77.62 / $151.36	Professional		$0.69	$77.62	$151.36
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.49 / $53.70 / $89.13	Professional	26	$0.49	$53.70	$89.13
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.20 / $25.70 / $66.07	Professional	TC	$0.20	$25.70	$66.07
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.69 / $0.69 / $144.54	Professional		$0.69	$0.69	$144.54
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.49 / $0.49 / $81.28	Professional	26	$0.49	$0.49	$81.28
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.20 / $0.20 / $63.10	Professional	TC	$0.20	$0.20	$63.10
Select Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $95.50 / $134.90	Professional		$93.33	$95.50	$134.90
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $53.70 / $77.62	Professional	26	$52.48	$53.70	$77.62
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $41.69 / $56.23	Professional	TC	$38.90	$41.69	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $109.65 / $173.78	Professional		$77.62	$109.65	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $117.49	Professional	26	$52.48	$72.44	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $37.15 / $69.18	Professional	TC	$26.30	$37.15	$69.18