Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $87.10 / $87.10	Facility	26	$87.10	$87.10	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $436.52 / $851.14	Professional		$363.08	$436.52	$851.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $100.00 / $436.52	Professional	26	$79.43	$100.00	$436.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $354.81 / $630.96	Professional	TC	$263.03	$354.81	$630.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $407.38 / $467.74	Professional		$389.05	$407.38	$467.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $87.10 / $158.49	Professional	26	$74.13	$87.10	$158.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $446.68 / $758.58	Professional		$302.00	$446.68	$758.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $97.72 / $151.36	Professional	26	$72.44	$97.72	$151.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $363.08 / $602.56	Professional	TC	$204.17	$363.08	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $478.63 / $794.33	Professional		$245.47	$478.63	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $112.20 / $162.18	Professional	26	$83.18	$112.20	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $380.19 / $660.69	Professional	TC	$158.49	$380.19	$660.69
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.63 / $524.81 / $758.58	Professional		$3.63	$524.81	$758.58
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.56 / $95.50 / $138.04	Professional	26	$0.56	$95.50	$138.04
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $3.09 / $436.52 / $616.60	Professional	TC	$3.09	$436.52	$616.60
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.63 / $3.63 / $724.44	Professional		$3.63	$3.63	$724.44
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.56 / $0.56 / $131.83	Professional	26	$0.56	$0.56	$131.83
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $3.09 / $3.09 / $588.84	Professional	TC	$3.09	$3.09	$588.84
Select Health Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $478.63 / $758.58	Professional		$426.58	$478.63	$758.58
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $87.10 / $158.49	Professional	26	$81.28	$87.10	$158.49
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $389.05 / $602.56	Professional	TC	$346.74	$389.05	$602.56
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $426.58 / $724.44	Professional		$263.03	$426.58	$724.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $104.71 / $147.91	Professional	26	$75.86	$104.71	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $331.13 / $588.84	Professional	TC	$199.53	$331.13	$588.84