Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $14.13 / $95.50	Facility	26	$12.02	$14.13	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $47.86 / $154.88	Professional		$28.18	$47.86	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.14 / $58.88	Professional	26	$10.96	$15.14	$58.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $32.36 / $58.88	Professional	TC	$23.99	$32.36	$58.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $30.20 / $36.31	Professional		$25.70	$30.20	$36.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $10.00 / $20.42	Professional	26	$9.55	$10.00	$20.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $36.31 / $61.66	Professional	TC	$20.89	$36.31	$61.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $39.81 / $67.61	Professional		$38.90	$39.81	$67.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $12.02 / $20.89	Professional	26	$11.48	$12.02	$20.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $28.18 / $45.71	Professional	TC	$26.92	$28.18	$45.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $79.43	Professional		$33.88	$47.86	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $16.22 / $23.99	Professional	26	$10.47	$16.22	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.90 / $56.23	Professional	TC	$21.88	$30.90	$56.23
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.36 / $50.12 / $67.61	Professional		$0.36	$50.12	$67.61
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.15 / $15.14 / $19.95	Professional	26	$0.15	$15.14	$19.95
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.21 / $35.48 / $46.77	Professional	TC	$0.21	$35.48	$46.77
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.36 / $0.36 / $63.10	Professional		$0.36	$0.36	$63.10
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.15 / $0.15 / $19.05	Professional	26	$0.15	$0.15	$19.05
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.21 / $0.21 / $43.65	Professional	TC	$0.21	$0.21	$43.65
Select Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $41.69 / $41.69	Professional		$40.74	$41.69	$41.69
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $12.59 / $12.59	Professional	26	$12.30	$12.59	$12.59
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $28.84 / $28.84	Professional	TC	$28.18	$28.84	$28.84
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $41.69 / $67.61	Professional		$29.51	$41.69	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $13.80 / $22.39	Professional	26	$9.55	$13.80	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $27.54 / $45.71	Professional	TC	$19.95	$27.54	$45.71