Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $125.89 / $151.36	Facility	26	$125.89	$125.89	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $794.33 / $1,905.46	Professional		$588.84	$794.33	$1,905.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $144.54 / $645.65	Professional	26	$114.82	$144.54	$645.65
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $194.98 / $575.44 / $588.84	Professional	52	$194.98	$575.44	$588.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $645.65 / $1,445.44	Professional	TC	$467.74	$645.65	$1,445.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $630.96 / $676.08	Professional		$575.44	$630.96	$676.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $125.89 / $162.18	Professional	26	$107.15	$125.89	$162.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $457.09 / $575.44	Professional	TC	$323.59	$457.09	$575.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $645.65 / $977.24	Professional		$549.54	$645.65	$977.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $125.89 / $190.55	Professional	26	$104.71	$125.89	$190.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $524.81 / $776.25	Professional	TC	$446.68	$524.81	$776.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $870.96 / $1,288.25	Professional		$616.60	$870.96	$1,288.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $181.97 / $257.04	Professional	26	$125.89	$181.97	$257.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $707.95 / $1,047.13	Professional	TC	$501.19	$707.95	$1,047.13
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $776.25 / $1,096.48	Professional		$5.01	$776.25	$1,096.48
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $2.51 / $134.90 / $190.55	Professional	26	$2.51	$134.90	$190.55
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.51 / $645.65 / $912.01	Professional	TC	$2.51	$645.65	$912.01
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $5.01 / $5.01 / $1,071.52	Professional		$5.01	$5.01	$1,071.52
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $2.51 / $2.51 / $186.21	Professional	26	$2.51	$2.51	$186.21
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.51 / $2.51 / $870.96	Professional	TC	$2.51	$2.51	$870.96
Select Health Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $707.95 / $1,071.52	Professional		$630.96	$707.95	$1,071.52
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $123.03 / $213.80	Professional	26	$117.49	$123.03	$213.80
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $588.84 / $851.14	Professional	TC	$524.81	$588.84	$851.14
United Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $891.25 / $1,202.26	Professional		$575.44	$891.25	$1,202.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $181.97 / $245.47	Professional	26	$117.49	$181.97	$245.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $724.44 / $977.24	Professional	TC	$489.78	$724.44	$977.24