Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $190.55 / $190.55 / $190.55	Facility	26	$190.55	$190.55	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $331.13 / $1,258.93	Professional		$269.15	$331.13	$1,258.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $194.98 / $933.25	Professional	26	$169.82	$194.98	$933.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $114.82 / $199.53	Professional	TC	$93.33	$114.82	$199.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $275.42 / $316.23	Professional		$257.04	$275.42	$316.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $158.49 / $169.82 / $190.55	Professional	26	$158.49	$169.82	$190.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $346.74 / $537.03	Professional		$245.47	$346.74	$537.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $213.80 / $338.84	Professional	26	$154.88	$213.80	$338.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $128.82 / $199.53	Professional	TC	$93.33	$128.82	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $380.19 / $549.54	Professional		$281.84	$380.19	$549.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $234.42 / $354.81	Professional	26	$169.82	$234.42	$354.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $138.04 / $194.98	Professional	TC	$107.15	$138.04	$194.98
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.19 / $331.13 / $467.74	Professional		$2.19	$331.13	$467.74
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.35 / $204.17 / $288.40	Professional	26	$1.35	$204.17	$288.40
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.85 / $123.03 / $177.83	Professional	TC	$0.85	$123.03	$177.83
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.19 / $2.19 / $446.68	Professional		$2.19	$2.19	$446.68
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.35 / $1.35 / $281.84	Professional	26	$1.35	$1.35	$281.84
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.85 / $0.85 / $169.82	Professional	TC	$0.85	$0.85	$169.82
Select Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $302.00 / $537.03	Professional		$275.42	$302.00	$537.03
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $177.83 / $186.21 / $346.74	Professional	26	$177.83	$186.21	$346.74
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $112.20 / $186.21	Professional	TC	$97.72	$112.20	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $371.54 / $501.19	Professional		$269.15	$371.54	$501.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $239.88 / $338.84	Professional	26	$169.82	$239.88	$338.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $147.91 / $204.17	Professional	TC	$104.71	$147.91	$204.17