Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $54.95	Facility	26	$44.67	$44.67	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $158.49 / $331.13	Professional		$125.89	$158.49	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $50.12 / $190.55	Professional	26	$39.81	$50.12	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $107.15 / $186.21	Professional	TC	$85.11	$107.15	$186.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $208.93 / $302.00	Professional		$138.04	$208.93	$302.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $63.10 / $93.33	Professional	26	$42.66	$63.10	$93.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $141.25 / $204.17	Professional	TC	$93.33	$141.25	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $204.17 / $275.42	Professional		$138.04	$204.17	$275.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $61.66 / $85.11	Professional	26	$44.67	$61.66	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $144.54 / $204.17	Professional	TC	$93.33	$144.54	$204.17
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.95 / $147.91 / $223.87	Professional		$2.95	$147.91	$223.87
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.00 / $47.86 / $72.44	Professional	26	$1.00	$47.86	$72.44
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.95 / $95.50 / $154.88	Professional	TC	$1.95	$95.50	$154.88
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.95 / $2.95 / $208.93	Professional		$2.95	$2.95	$208.93
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.00 / $1.00 / $64.57	Professional	26	$1.00	$1.00	$64.57
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.95 / $1.95 / $141.25	Professional	TC	$1.95	$1.95	$141.25
Select Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $138.04 / $186.21	Professional		$131.83	$138.04	$186.21
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $42.66 / $61.66	Professional	26	$41.69	$42.66	$61.66
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $95.50 / $125.89	Professional	TC	$89.13	$95.50	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $199.53 / $281.84	Professional		$128.82	$199.53	$281.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $54.95 / $85.11	Professional	26	$40.74	$54.95	$85.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $141.25 / $213.80	Professional	TC	$85.11	$141.25	$213.80