Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $38.02 / $38.02	Facility	26	$38.02	$38.02	$38.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $87.10 / $416.87	Professional		$41.69	$87.10	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $53.70 / $194.98	Professional	26	$33.88	$53.70	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $33.88 / $158.49	Professional	TC	$25.12	$33.88	$158.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $30.20 / $63.10	Professional		$24.55	$30.20	$63.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $39.81 / $41.69	Professional	26	$29.51	$39.81	$41.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $12.02 / $12.02	Professional	TC	$12.02	$12.02	$12.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $93.33 / $218.78	Professional		$57.54	$93.33	$218.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $52.48 / $85.11	Professional	26	$33.11	$52.48	$85.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $38.90 / $138.04	Professional	TC	$25.12	$38.90	$138.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $28.18 / $28.18	Facility		$28.18	$28.18	$28.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $123.03 / $309.03	Professional		$72.44	$123.03	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $64.57 / $114.82	Professional	26	$39.81	$64.57	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $53.70 / $190.55	Professional	TC	$30.90	$53.70	$190.55
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $3.24 / $79.43 / $125.89	Professional		$3.24	$79.43	$125.89
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.48 / $43.65 / $61.66	Professional	26	$1.48	$43.65	$61.66
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.00 / $36.31 / $51.29	Professional	TC	$2.00	$36.31	$51.29
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.75 / $2.75 / $100.00	Professional		$2.75	$2.75	$100.00
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.26 / $1.26 / $54.95	Professional	26	$1.26	$1.26	$54.95
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $43.65 / $45.71	Professional	TC	$43.65	$43.65	$45.71
Select Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $66.07 / $117.49	Professional		$61.66	$66.07	$117.49
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $36.31 / $67.61	Professional	26	$34.67	$36.31	$67.61
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $29.51 / $47.86	Professional	TC	$26.92	$29.51	$47.86
United Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $1,288.25 / $2,041.74	Facility		$199.53	$1,288.25	$2,041.74
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $114.82 / $281.84	Professional		$64.57	$114.82	$281.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $67.61 / $107.15	Professional	26	$37.15	$67.61	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $51.29 / $177.83	Professional	TC	$26.92	$51.29	$177.83