Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $15.14 / $18.20	Facility	26	$15.14	$15.14	$18.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $57.54 / $281.84	Professional		$42.66	$57.54	$281.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.98 / $64.57	Professional	26	$12.88	$16.98	$64.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $38.90 / $74.13	Professional	TC	$30.20	$38.90	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $39.81 / $57.54	Professional		$33.88	$39.81	$57.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $12.02 / $24.55	Professional	26	$11.22	$12.02	$24.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $22.91 / $22.91	Professional	TC	$22.91	$22.91	$22.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $50.12 / $85.11	Professional		$48.98	$50.12	$85.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $14.13 / $24.55	Professional	26	$13.49	$14.13	$24.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $35.48 / $58.88	Professional	TC	$35.48	$35.48	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $60.26 / $97.72	Professional		$43.65	$60.26	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $19.05 / $28.84	Professional	26	$12.88	$19.05	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $41.69 / $70.79	Professional	TC	$30.20	$41.69	$70.79
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.43 / $61.66 / $81.28	Professional		$0.43	$61.66	$81.28
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.17 / $17.78 / $23.99	Professional	26	$0.17	$17.78	$23.99
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.26 / $43.65 / $58.88	Professional	TC	$0.26	$43.65	$58.88
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.43 / $0.43 / $77.62	Professional		$0.43	$0.43	$77.62
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.17 / $0.17 / $22.39	Professional	26	$0.17	$0.17	$22.39
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.26 / $0.26 / $54.95	Professional	TC	$0.26	$0.26	$54.95
Select Health Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $51.29 / $51.29	Professional		$50.12	$51.29	$51.29
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $14.79 / $14.79	Professional	26	$14.79	$14.79	$14.79
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $36.31 / $36.31	Professional	TC	$35.48	$36.31	$36.31
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $52.48 / $85.11	Professional		$38.90	$52.48	$85.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.60 / $27.54	Professional	26	$10.96	$16.60	$27.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $35.48 / $61.66	Professional	TC	$28.18	$35.48	$61.66