Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.33 / $27.33 / $29.52	Facility	26	$27.33	$27.33	$29.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.72 / $167.95 / $222.79	Professional		$133.72	$167.95	$222.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $107.62 / $138.44 / $185.54	Professional	TC	$107.62	$138.44	$185.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.14 / $148.81 / $242.80	Professional		$106.14	$148.81	$242.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.62 / $122.85 / $208.53	Professional	TC	$84.62	$122.85	$208.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.81 / $176.34 / $279.92	Professional		$74.81	$176.34	$279.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.64 / $144.47 / $230.73	Professional	TC	$46.64	$144.47	$230.73
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.40 / $195.68 / $268.85	Professional		$1.40	$195.68	$268.85
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.15 / $30.57 / $41.69	Professional	26	$0.15	$30.57	$41.69
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.25 / $164.69 / $226.27	Professional	TC	$1.25	$164.69	$226.27
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.40 / $170.81 / $255.24	Professional		$1.40	$170.81	$255.24
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.25 / $143.21 / $214.82	Professional	TC	$1.25	$143.21	$214.82
United Facility/Professional Professional Modifier Low / Median / High Price $96.02 / $158.41 / $255.01	Professional		$96.02	$158.41	$255.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.98 / $116.59 / $232.86	Professional	TC	$73.98	$116.59	$232.86