Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.35 / $72.22 / $76.02	Facility	26	$63.35	$72.22	$76.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.11 / $255.31 / $1,221.11	Professional		$200.11	$255.31	$1,221.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.81 / $72.22 / $335.70	Professional	26	$59.81	$72.22	$335.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $143.60 / $166.43 / $774.00	Professional	TC	$143.60	$166.43	$774.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $220.97 / $269.33 / $407.34	Professional		$220.97	$269.33	$407.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $86.42 / $121.52	Professional	26	$60.26	$86.42	$121.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.13 / $185.10 / $294.75	Professional	TC	$162.13	$185.10	$294.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.84 / $279.52 / $416.56	Professional		$186.84	$279.52	$416.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.71 / $82.61 / $114.03	Professional	26	$59.71	$82.61	$114.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $142.21 / $196.32 / $300.52	Professional	TC	$142.21	$196.32	$300.52
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.75 / $253.26 / $372.37	Professional		$2.75	$253.26	$372.37
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.00 / $69.89 / $101.15	Professional	26	$1.00	$69.89	$101.15
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.75 / $176.35 / $270.67	Professional	TC	$1.75	$176.35	$270.67
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.75 / $208.28 / $330.35	Professional		$2.75	$208.28	$330.35
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.00 / $59.91 / $89.87	Professional	26	$1.00	$59.91	$89.87
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.75 / $160.32 / $240.48	Professional	TC	$1.75	$160.32	$240.48
United Facility/Professional Professional Modifier Low / Median / High Price $204.63 / $270.62 / $442.33	Professional		$204.63	$270.62	$442.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.12 / $79.64 / $123.08	Professional	26	$58.12	$79.64	$123.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $152.19 / $198.47 / $319.58	Professional	TC	$152.19	$198.47	$319.58