Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.70 / $62.32 / $69.23	Facility	26	$57.70	$62.32	$69.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.93 / $294.64 / $1,239.00	Professional		$246.93	$294.64	$1,239.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.84 / $102.05 / $383.68	Professional	26	$55.84	$102.05	$383.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $197.19 / $388.49	Professional	TC	$162.34	$197.19	$388.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.24 / $201.62 / $446.19	Professional		$169.24	$201.62	$446.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.09 / $76.95 / $95.19	Professional	26	$40.09	$76.95	$95.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $243.05 / $276.88 / $347.60	Professional		$243.05	$276.88	$347.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.82 / $56.41 / $110.69	Professional	26	$51.82	$56.41	$110.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $162.15 / $220.46 / $231.54	Professional	TC	$162.15	$220.46	$231.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.80 / $382.47 / $567.66	Professional		$257.80	$382.47	$567.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.98 / $89.44 / $129.88	Professional	26	$55.98	$89.44	$129.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $202.45 / $299.79 / $436.20	Professional	TC	$202.45	$299.79	$436.20
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.68 / $297.48 / $436.73	Professional		$4.68	$297.48	$436.73
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.68 / $68.41 / $97.35	Professional	26	$1.68	$68.41	$97.35
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.48 / $216.37 / $347.91	Professional	TC	$2.48	$216.37	$347.91
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $4.68 / $252.02 / $388.02	Professional		$4.68	$252.02	$388.02
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.89 / $52.62 / $78.93	Professional	26	$1.89	$52.62	$78.93
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.79 / $206.07 / $309.11	Professional	TC	$2.79	$206.07	$309.11
United Facility/Professional Professional Modifier Low / Median / High Price $265.32 / $387.22 / $598.57	Professional		$265.32	$387.22	$598.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.93 / $88.03 / $136.16	Professional	26	$53.93	$88.03	$136.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.59 / $297.89 / $456.00	Professional	TC	$204.59	$297.89	$456.00