Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.59 / $97.58 / $102.71	Facility	26	$85.59	$97.58	$102.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.66 / $277.24 / $1,141.41	Professional		$231.66	$277.24	$1,141.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.10 / $97.12 / $378.00	Professional	26	$82.10	$97.12	$378.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $137.69 / $165.09 / $279.43	Professional	TC	$137.69	$165.09	$279.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $232.38 / $317.47 / $466.19	Professional		$232.38	$317.47	$466.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.23 / $122.25 / $171.92	Professional	26	$81.23	$122.25	$171.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.34 / $195.22 / $296.50	Professional	TC	$151.34	$195.22	$296.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $212.47 / $304.54 / $444.45	Professional		$212.47	$304.54	$444.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.08 / $109.93 / $154.07	Professional	26	$79.08	$109.93	$154.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.51 / $190.10 / $286.08	Professional	TC	$131.51	$190.10	$286.08
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.20 / $268.43 / $394.08	Professional		$2.20	$268.43	$394.08
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.80 / $92.98 / $136.50	Professional	26	$0.80	$92.98	$136.50
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.40 / $175.46 / $257.58	Professional	TC	$1.40	$175.46	$257.58
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.20 / $222.09 / $350.13	Professional		$2.20	$222.09	$350.13
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.80 / $80.84 / $121.28	Professional	26	$0.80	$80.84	$121.28
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.40 / $152.57 / $228.86	Professional	TC	$1.40	$152.57	$228.86
United Facility/Professional Professional Modifier Low / Median / High Price $222.09 / $300.51 / $450.83	Professional		$222.09	$300.51	$450.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.87 / $113.74 / $166.99	Professional	26	$79.87	$113.74	$166.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $143.13 / $192.72 / $286.26	Professional	TC	$143.13	$192.72	$286.26