Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $309.03 / $309.03 / $309.03	Facility	26	$309.03	$309.03	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,230.27 / $4,897.79	Professional		$1,047.13	$1,230.27	$4,897.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $288.40 / $380.19 / $1,479.11	Professional	26	$288.40	$380.19	$1,479.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $776.25 / $870.96 / $1,412.54	Professional	TC	$776.25	$870.96	$1,412.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $251.19 / $316.23 / $489.78	Professional	26	$251.19	$316.23	$489.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,445.44 / $2,089.30	Professional		$1,122.02	$1,445.44	$2,089.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $302.00 / $398.11 / $575.44	Professional	26	$302.00	$398.11	$575.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $831.76 / $1,071.52 / $1,445.44	Professional	TC	$831.76	$1,071.52	$1,445.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $933.25 / $1,148.15 / $1,737.80	Professional		$933.25	$1,148.15	$1,737.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $263.03 / $346.74 / $478.63	Professional	26	$263.03	$346.74	$478.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $660.69 / $812.83 / $1,258.93	Professional	TC	$660.69	$812.83	$1,258.93
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $1,230.27 / $1,778.28	Professional		$10.47	$1,230.27	$1,778.28
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.16 / $346.74 / $489.78	Professional	26	$3.16	$346.74	$489.78
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $707.95 / $1,174.90 / $2,691.53	Professional	TC	$707.95	$1,174.90	$2,691.53
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $10.47 / $1,513.56	Professional		$10.47	$10.47	$1,513.56
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.16 / $3.16 / $426.58	Professional	26	$3.16	$3.16	$426.58
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,096.48 / $1,096.48 / $2,691.53	Professional	TC	$1,096.48	$1,096.48	$2,691.53
Select Health Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Professional		$1,000.00	$1,000.00	$1,000.00
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $281.84 / $281.84 / $281.84	Professional	26	$281.84	$281.84	$281.84
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $724.44 / $724.44 / $724.44	Professional	TC	$724.44	$724.44	$724.44
United Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,348.96 / $1,862.09	Professional		$977.24	$1,348.96	$1,862.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $302.00 / $426.58 / $537.03	Professional	26	$302.00	$426.58	$537.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $758.58 / $1,023.29 / $1,380.38	Professional	TC	$758.58	$1,023.29	$1,380.38