Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.56 / $12.92 / $15.50	Facility	26	$12.56	$12.92	$15.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.66 / $63.18 / $274.08	Facility	TC	$29.66	$63.18	$274.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.39 / $42.58 / $223.00	Professional		$35.39	$42.58	$223.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.53 / $13.85 / $31.92	Professional	26	$12.53	$13.85	$31.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.85 / $29.66 / $54.42	Professional	TC	$22.85	$29.66	$54.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.88 / $39.88 / $39.88	Professional		$39.88	$39.88	$39.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.03 / $10.03 / $10.03	Professional	26	$10.03	$10.03	$10.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.59 / $43.42 / $60.32	Professional		$37.59	$43.42	$60.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.89 / $14.26 / $18.30	Professional	26	$10.89	$14.26	$18.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.92 / $30.61 / $42.13	Professional	TC	$24.92	$30.61	$42.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.36 / $48.28 / $79.01	Professional		$31.36	$48.28	$79.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $16.93 / $23.97	Professional	26	$11.14	$16.93	$23.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.21 / $32.17 / $55.03	Professional	TC	$20.21	$32.17	$55.03
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.34 / $49.20 / $68.47	Professional		$0.34	$49.20	$68.47
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.14 / $15.91 / $21.11	Professional	26	$0.14	$15.91	$21.11
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.21 / $32.61 / $45.38	Professional	TC	$0.21	$32.61	$45.38
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.34 / $40.65 / $61.50	Professional		$0.34	$40.65	$61.50
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.14 / $12.64 / $18.96	Professional	26	$0.14	$12.64	$18.96
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.21 / $28.36 / $42.54	Professional	TC	$0.21	$28.36	$42.54
United Facility/Professional Professional Modifier Low / Median / High Price $32.86 / $41.86 / $76.87	Professional		$32.86	$41.86	$76.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.37 / $14.48 / $26.51	Professional	26	$11.37	$14.48	$26.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $27.79 / $48.51	Professional	TC	$19.89	$27.79	$48.51