Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $135.22 / $135.22 / $146.05	Facility	26	$135.22	$135.22	$146.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.89 / $240.87 / $640.00	Professional		$199.89	$240.87	$640.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.43 / $134.81 / $202.74	Professional	26	$118.43	$134.81	$202.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.72 / $92.39 / $137.05	Professional	TC	$76.72	$92.39	$137.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $200.96 / $200.96 / $266.77	Professional		$200.96	$200.96	$266.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $270.95 / $270.95 / $270.95	Professional	26	$270.95	$270.95	$270.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.98 / $262.52 / $359.97	Professional		$181.98	$262.52	$359.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.73 / $149.97 / $200.36	Professional	26	$109.73	$149.97	$200.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.90 / $106.17 / $147.21	Professional	TC	$75.90	$106.17	$147.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.09 / $281.52 / $401.85	Professional		$201.09	$281.52	$401.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $115.99 / $168.55 / $243.41	Professional	26	$115.99	$168.55	$243.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.56 / $111.28 / $158.44	Professional	TC	$80.56	$111.28	$158.44
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.60 / $252.64 / $347.11	Professional		$1.60	$252.64	$347.11
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.60 / $145.88 / $202.19	Professional	26	$0.60	$145.88	$202.19
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.00 / $100.67 / $138.31	Professional	TC	$1.00	$100.67	$138.31
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.60 / $200.96 / $329.54	Professional		$1.60	$200.96	$329.54
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.60 / $132.15 / $198.23	Professional	26	$0.60	$132.15	$198.23
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.00 / $87.54 / $131.31	Professional	TC	$1.00	$87.54	$131.31
United Facility/Professional Professional Modifier Low / Median / High Price $206.66 / $282.50 / $428.34	Professional		$206.66	$282.50	$428.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $124.64 / $167.64 / $255.27	Professional	26	$124.64	$167.64	$255.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.76 / $109.60 / $174.46	Professional	TC	$85.76	$109.60	$174.46