Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.10 / $132.94 / $147.72	Facility		$123.10	$132.94	$147.72
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.57 / $26.54 / $29.48	Facility	26	$24.57	$26.54	$29.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.79 / $123.10 / $593.00	Professional		$105.79	$123.10	$593.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $24.14 / $105.00	Professional	26	$20.50	$24.14	$105.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.20 / $102.26 / $175.65	Professional	TC	$86.20	$102.26	$175.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.98 / $122.17 / $170.38	Professional		$110.98	$122.17	$170.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.25 / $23.88 / $29.03	Professional	26	$21.25	$23.88	$29.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.73 / $98.29 / $140.02	Professional	TC	$89.73	$98.29	$140.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.44 / $203.39 / $670.85	Facility		$120.44	$203.39	$670.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.52 / $167.23 / $244.46	Professional		$113.52	$167.23	$244.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.45 / $29.11 / $43.32	Professional	26	$20.45	$29.11	$43.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.58 / $140.63 / $204.19	Professional	TC	$90.58	$140.63	$204.19
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.79 / $139.86 / $203.96	Professional		$2.79	$139.86	$203.96
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.40 / $25.00 / $38.36	Professional	26	$0.40	$25.00	$38.36
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.08 / $110.43 / $158.43	Professional	TC	$2.08	$110.43	$158.43
Hometown Health Facility/Professional Facility Modifier Low / Median / High Price $117.52 / $117.52 / $117.52	Facility		$117.52	$117.52	$117.52
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.79 / $112.54 / $174.83	Professional		$2.79	$112.54	$174.83
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.45 / $22.72 / $34.08	Professional	26	$0.45	$22.72	$34.08
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.34 / $93.84 / $140.76	Professional	TC	$2.34	$93.84	$140.76
United Facility/Professional Facility Modifier Low / Median / High Price $123.10 / $123.10 / $123.10	Facility		$123.10	$123.10	$123.10
United Facility/Professional Professional Modifier Low / Median / High Price $114.30 / $165.30 / $251.55	Professional		$114.30	$165.30	$251.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.41 / $28.70 / $47.60	Professional	26	$21.41	$28.70	$47.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.70 / $141.81 / $213.63	Professional	TC	$91.70	$141.81	$213.63