Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.56 / $13.25 / $131.46	Facility	26	$12.56	$13.25	$131.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $70.28 / $212.74	Professional		$53.00	$70.28	$212.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.56 / $20.75 / $66.00	Professional	26	$13.56	$20.75	$66.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.60 / $48.43 / $143.00	Professional	TC	$38.60	$48.43	$143.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.10 / $41.84 / $79.50	Professional		$40.10	$41.84	$79.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.05 / $18.59 / $27.37	Professional	26	$10.05	$18.59	$27.37
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $48.44 / $48.44 / $48.44	Professional	TC	$48.44	$48.44	$48.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.35 / $54.50 / $75.64	Professional		$46.35	$54.50	$75.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $15.72 / $20.10	Professional	26	$10.68	$15.72	$20.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.68 / $38.10 / $50.11	Professional	TC	$33.68	$38.10	$50.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.74 / $60.84 / $99.56	Professional		$41.74	$60.84	$99.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.60 / $18.82 / $25.13	Professional	26	$12.60	$18.82	$25.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.35 / $43.73 / $76.06	Professional	TC	$30.35	$43.73	$76.06
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.43 / $65.23 / $91.83	Professional		$0.43	$65.23	$91.83
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.15 / $16.80 / $21.81	Professional	26	$0.15	$16.80	$21.81
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.28 / $48.38 / $67.31	Professional	TC	$0.28	$48.38	$67.31
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.43 / $52.30 / $82.49	Professional		$0.43	$52.30	$82.49
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.15 / $12.92 / $19.38	Professional	26	$0.15	$12.92	$19.38
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.28 / $42.07 / $63.11	Professional	TC	$0.28	$42.07	$63.11
United Facility/Professional Professional Modifier Low / Median / High Price $41.22 / $51.25 / $93.28	Professional		$41.22	$51.25	$93.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.26 / $15.30 / $27.68	Professional	26	$11.26	$15.30	$27.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.14 / $37.18 / $67.67	Professional	TC	$28.14	$37.18	$67.67