Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.89 / $13.59 / $16.30	Facility	26	$12.89	$13.59	$16.30
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.67 / $67.45 / $500.12	Facility	TC	$31.67	$67.45	$500.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.67 / $49.93 / $248.06	Professional		$42.67	$49.93	$248.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.59 / $16.12 / $80.12	Professional	26	$13.59	$16.12	$80.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.17 / $32.27 / $58.83	Professional	TC	$28.17	$32.27	$58.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.30 / $23.85 / $23.85	Professional	26	$10.30	$23.85	$23.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.29 / $49.04 / $59.51	Professional		$42.29	$49.04	$59.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.70 / $17.30 / $20.76	Professional	26	$12.70	$17.30	$20.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.90 / $31.46 / $38.29	Professional	TC	$25.90	$31.46	$38.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.47 / $58.35 / $84.32	Professional		$38.47	$58.35	$84.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.26 / $20.04 / $25.78	Professional	26	$13.26	$20.04	$25.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.32 / $37.54 / $60.71	Professional	TC	$26.32	$37.54	$60.71
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.45 / $56.78 / $72.95	Professional		$0.45	$56.78	$72.95
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.18 / $16.86 / $21.90	Professional	26	$0.18	$16.86	$21.90
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.27 / $38.38 / $50.31	Professional	TC	$0.27	$38.38	$50.31
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.45 / $43.24 / $65.52	Professional		$0.45	$43.24	$65.52
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.18 / $12.97 / $19.46	Professional	26	$0.18	$12.97	$19.46
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.27 / $30.70 / $46.05	Professional	TC	$0.27	$30.70	$46.05
United Facility/Professional Professional Modifier Low / Median / High Price $37.51 / $48.29 / $82.79	Professional		$37.51	$48.29	$82.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.22 / $15.98 / $27.38	Professional	26	$12.22	$15.98	$27.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.29 / $30.26 / $55.41	Professional	TC	$25.29	$30.26	$55.41