Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.65 / $71.42 / $75.18	Facility	26	$62.65	$71.42	$75.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.76 / $108.68 / $416.00	Professional		$90.76	$108.68	$416.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.32 / $66.06 / $281.00	Professional	26	$53.32	$66.06	$281.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.48 / $35.27 / $77.38	Professional	TC	$28.48	$35.27	$77.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.57 / $85.57 / $85.57	Professional		$85.57	$85.57	$85.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.13 / $98.74 / $161.78	Professional		$77.13	$98.74	$161.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.88 / $67.84 / $101.51	Professional	26	$50.88	$67.84	$101.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.98 / $29.54 / $67.98	Professional	TC	$19.98	$29.54	$67.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.27 / $106.31 / $173.46	Professional		$79.27	$106.31	$173.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.43 / $71.53 / $106.50	Professional	26	$54.43	$71.53	$106.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.39 / $36.54 / $76.36	Professional	TC	$24.39	$36.54	$76.36
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.80 / $103.99 / $164.30	Professional		$0.80	$103.99	$164.30
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.55 / $61.86 / $98.38	Professional	26	$0.55	$61.86	$98.38
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.25 / $45.08 / $75.28	Professional	TC	$0.25	$45.08	$75.28
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.80 / $100.67 / $155.99	Professional		$0.80	$100.67	$155.99
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.55 / $58.91 / $88.37	Professional	26	$0.55	$58.91	$88.37
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.25 / $45.08 / $67.62	Professional	TC	$0.25	$45.08	$67.62
United Facility/Professional Professional Modifier Low / Median / High Price $88.69 / $118.02 / $188.63	Professional		$88.69	$118.02	$188.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.15 / $80.09 / $126.00	Professional	26	$57.15	$80.09	$126.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.64 / $42.01 / $72.27	Professional	TC	$29.64	$42.01	$72.27