Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $25.70 / $31.62	Facility	26	$25.70	$25.70	$31.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $134.90 / $239.88	Professional		$102.33	$134.90	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $28.84 / $58.88	Professional	26	$22.91	$28.84	$58.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $109.65 / $190.55	Professional	TC	$69.18	$109.65	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $134.90	Professional		$131.83	$131.83	$134.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Professional	26	$74.13	$74.13	$74.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $165.96 / $181.97	Professional		$109.65	$165.96	$181.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $25.70 / $39.81	Professional	26	$25.70	$25.70	$39.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $141.25 / $141.25	Professional	TC	$74.13	$141.25	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $229.09 / $316.23	Professional		$154.88	$229.09	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $38.02 / $58.88	Professional	26	$25.12	$38.02	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $194.98 / $269.15	Professional	TC	$128.82	$194.98	$269.15
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.39 / $141.25 / $229.09	Professional		$3.39	$141.25	$229.09
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.72 / $35.48 / $57.54	Professional	26	$0.72	$35.48	$57.54
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.69 / $107.15 / $169.82	Professional	TC	$2.69	$107.15	$169.82
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.39 / $3.39 / $213.80	Professional		$3.39	$3.39	$213.80
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.72 / $0.72 / $53.70	Professional	26	$0.72	$0.72	$53.70
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.69 / $2.69 / $158.49	Professional	TC	$2.69	$2.69	$158.49
Select Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $141.25 / $245.47	Professional		$138.04	$141.25	$245.47
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $35.48 / $56.23	Professional	26	$33.88	$35.48	$56.23
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $107.15 / $190.55	Professional	TC	$107.15	$107.15	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $208.93 / $316.23	Professional		$147.91	$208.93	$316.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $35.48 / $53.70	Professional	26	$23.99	$35.48	$53.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $177.83 / $269.15	Professional	TC	$125.89	$177.83	$269.15