Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.45 / $17.30 / $20.76	Facility	26	$16.45	$17.30	$20.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.64 / $82.68 / $320.00	Professional		$61.64	$82.68	$320.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.61 / $17.80 / $38.09	Professional	26	$15.61	$17.80	$38.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.00 / $61.88 / $118.29	Professional	TC	$46.00	$61.88	$118.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.33 / $59.33 / $59.33	Professional		$59.33	$59.33	$59.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.09 / $13.09 / $13.09	Professional	26	$13.09	$13.09	$13.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.66 / $83.09 / $113.17	Professional		$71.66	$83.09	$113.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.84 / $19.89 / $26.87	Professional	26	$14.84	$19.89	$26.87
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.71 / $64.81 / $88.09	Professional	TC	$56.71	$64.81	$88.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.33 / $88.86 / $146.93	Professional		$54.33	$88.86	$146.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.95 / $21.89 / $32.10	Professional	26	$13.95	$21.89	$32.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.38 / $67.64 / $114.83	Professional	TC	$40.38	$67.64	$114.83
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.32 / $88.61 / $133.15	Professional		$0.32	$88.61	$133.15
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.11 / $20.32 / $27.09	Professional	26	$0.11	$20.32	$27.09
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.21 / $72.22 / $100.48	Professional	TC	$0.21	$72.22	$100.48
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.32 / $77.48 / $119.60	Professional		$0.32	$77.48	$119.60
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.11 / $16.93 / $25.40	Professional	26	$0.11	$16.93	$25.40
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.21 / $89.34 / $94.20	Professional	TC	$0.21	$89.34	$94.20
United Facility/Professional Professional Modifier Low / Median / High Price $54.00 / $79.76 / $136.81	Professional		$54.00	$79.76	$136.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.40 / $18.77 / $34.15	Professional	26	$14.40	$18.77	$34.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.81 / $60.99 / $106.42	Professional	TC	$41.81	$60.99	$106.42