Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $85.11 / $102.33	Facility	26	$85.11	$85.11	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $346.74 / $1,148.15	Professional		$239.88	$346.74	$1,148.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $114.82 / $398.11	Professional	26	$79.43	$114.82	$398.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $177.83 / $295.12	Professional	TC	$138.04	$177.83	$295.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $213.80 / $257.04	Professional		$199.53	$213.80	$257.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $91.20 / $100.00	Professional	26	$70.79	$91.20	$100.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $323.59 / $512.86	Professional		$234.42	$323.59	$512.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $125.89 / $181.97	Professional	26	$81.28	$125.89	$181.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $199.53 / $323.59	Professional	TC	$125.89	$199.53	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $316.23 / $446.68	Professional		$229.09	$316.23	$446.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $114.82 / $158.49	Professional	26	$81.28	$114.82	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $199.53 / $295.12	Professional	TC	$151.36	$199.53	$295.12
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.19 / $257.04 / $380.19	Professional		$2.19	$257.04	$380.19
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.79 / $89.13 / $131.83	Professional	26	$0.79	$89.13	$131.83
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.41 / $165.96 / $251.19	Professional	TC	$1.41	$165.96	$251.19
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.19 / $2.19 / $346.74	Professional		$2.19	$2.19	$346.74
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.79 / $0.79 / $120.23	Professional	26	$0.79	$0.79	$120.23
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.41 / $1.41 / $229.09	Professional	TC	$1.41	$1.41	$229.09
Select Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $234.42 / $316.23	Professional		$223.87	$234.42	$316.23
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $81.28 / $114.82	Professional	26	$77.62	$81.28	$114.82
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $151.36 / $204.17	Professional	TC	$144.54	$151.36	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $295.12 / $446.68	Professional		$218.78	$295.12	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $109.65 / $165.96	Professional	26	$77.62	$109.65	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $190.55 / $281.84	Professional	TC	$138.04	$190.55	$281.84