Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $12.02 / $15.14	Facility	26	$12.02	$12.02	$15.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $47.86 / $169.82	Professional		$38.02	$47.86	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $13.18 / $58.88	Professional	26	$10.00	$13.18	$58.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $34.67 / $67.61	Professional	TC	$26.92	$34.67	$67.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $33.11 / $46.77	Professional		$29.51	$33.11	$46.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.55 / $10.00	Professional	26	$8.51	$9.55	$10.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $25.12 / $27.54	Professional	TC	$21.88	$25.12	$27.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $44.67 / $77.62	Professional		$40.74	$44.67	$77.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $12.30 / $20.42	Professional	26	$11.75	$12.30	$20.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $33.11 / $54.95	Professional	TC	$28.84	$33.11	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $51.29 / $89.13	Professional		$36.31	$51.29	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $15.49 / $23.44	Professional	26	$10.23	$15.49	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $36.31 / $66.07	Professional	TC	$25.70	$36.31	$66.07
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.36 / $56.23 / $74.13	Professional		$0.36	$56.23	$74.13
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.13 / $14.79 / $19.50	Professional	26	$0.13	$14.79	$19.50
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.23 / $41.69 / $54.95	Professional	TC	$0.23	$41.69	$54.95
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.36 / $0.36 / $70.79	Professional		$0.36	$0.36	$70.79
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.13 / $0.13 / $18.62	Professional	26	$0.13	$0.13	$18.62
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.23 / $0.23 / $51.29	Professional	TC	$0.23	$0.23	$51.29
Select Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $46.77 / $46.77	Professional		$44.67	$46.77	$46.77
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $12.30 / $12.30	Professional	26	$12.02	$12.30	$12.30
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $34.67 / $34.67	Professional	TC	$33.11	$34.67	$34.67
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $46.77 / $75.86	Professional		$32.36	$46.77	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $13.80 / $21.88	Professional	26	$9.12	$13.80	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $33.11 / $53.70	Professional	TC	$23.44	$33.11	$53.70