Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.05 / $148.05 / $148.05	Facility		$148.05	$148.05	$148.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.44 / $27.44 / $27.44	Facility	26	$27.44	$27.44	$27.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.82 / $135.81 / $223.86	Professional		$113.82	$135.81	$223.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $20.71 / $32.56	Professional	26	$11.77	$20.71	$32.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.20 / $111.67 / $189.87	Professional	TC	$95.20	$111.67	$189.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.20 / $123.20 / $123.20	Professional		$123.20	$123.20	$123.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.39 / $153.66 / $161.86	Professional		$107.39	$153.66	$161.86
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.34 / $24.22 / $25.12	Professional	26	$13.34	$24.22	$25.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $94.05 / $129.44 / $136.74	Professional	TC	$94.05	$129.44	$136.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.13 / $190.09 / $300.18	Professional		$129.13	$190.09	$300.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.22 / $22.85 / $42.99	Professional	26	$12.22	$22.85	$42.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.75 / $164.85 / $269.70	Professional	TC	$112.75	$164.85	$269.70
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.40 / $135.25 / $203.52	Professional		$1.40	$135.25	$203.52
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.20 / $17.92 / $32.99	Professional	26	$0.20	$17.92	$32.99
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.20 / $115.69 / $161.30	Professional	TC	$1.20	$115.69	$161.30
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 $1.40 / $128.81 / $193.22	Professional		$1.40	$128.81	$193.22
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.20 / $21.99 / $32.99	Professional	26	$0.20	$21.99	$32.99
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.20 / $106.82 / $160.22	Professional	TC	$1.20	$106.82	$160.22
United Facility/Professional Professional Modifier Low / Median / High Price $139.46 / $192.91 / $294.68	Professional		$139.46	$192.91	$294.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.08 / $23.43 / $41.35	Professional	26	$12.08	$23.43	$41.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.76 / $169.99 / $266.55	Professional	TC	$117.76	$169.99	$266.55