Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $12.88 / $16.60	Facility	26	$12.88	$12.88	$16.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $44.67 / $107.15	Professional		$34.67	$44.67	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.13 / $29.51	Professional	26	$10.96	$14.13	$29.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $30.90 / $61.66	Professional	TC	$23.44	$30.90	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $32.36 / $42.66	Professional		$28.18	$32.36	$42.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $10.23 / $21.38	Professional	26	$10.23	$10.23	$21.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $19.95 / $29.51	Professional	TC	$19.95	$19.95	$29.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $41.69 / $70.79	Professional		$39.81	$41.69	$70.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $12.88 / $22.39	Professional	26	$12.30	$12.88	$22.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $28.84 / $46.77	Professional	TC	$27.54	$28.84	$46.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $50.12 / $83.18	Professional		$34.67	$50.12	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.60 / $25.70	Professional	26	$10.96	$16.60	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $34.67 / $57.54	Professional	TC	$23.99	$34.67	$57.54
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.39 / $51.29 / $69.18	Professional		$0.39	$51.29	$69.18
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.15 / $15.85 / $21.38	Professional	26	$0.15	$15.85	$21.38
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.23 / $35.48 / $47.86	Professional	TC	$0.23	$35.48	$47.86
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.39 / $0.39 / $64.57	Professional		$0.39	$0.39	$64.57
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.15 / $0.15 / $19.95	Professional	26	$0.15	$0.15	$19.95
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.23 / $0.23 / $44.67	Professional	TC	$0.23	$0.23	$44.67
Select Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $42.66 / $42.66	Professional		$42.66	$42.66	$42.66
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $13.18 / $13.18	Professional	26	$13.18	$13.18	$13.18
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $29.51 / $29.51	Professional	TC	$28.84	$29.51	$29.51
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $43.65 / $70.79	Professional		$31.62	$43.65	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $15.14 / $24.55	Professional	26	$9.55	$15.14	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $28.18 / $50.12	Professional	TC	$22.39	$28.18	$50.12