Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.30 / $20.45 / $24.54	Facility	26	$19.30	$20.45	$24.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.54 / $101.60 / $445.00	Professional		$78.54	$101.60	$445.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.16 / $21.49 / $45.95	Professional	26	$18.16	$21.49	$45.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.57 / $79.00 / $147.28	Professional	TC	$55.57	$79.00	$147.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.18 / $76.18 / $76.18	Professional		$76.18	$76.18	$76.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.50 / $15.50 / $15.50	Professional	26	$15.50	$15.50	$15.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.84 / $102.42 / $141.24	Professional		$87.84	$102.42	$141.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.79 / $23.05 / $31.24	Professional	26	$17.79	$23.05	$31.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.80 / $82.08 / $112.30	Professional	TC	$66.80	$82.08	$112.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.89 / $108.12 / $184.54	Professional		$64.89	$108.12	$184.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.16 / $25.38 / $37.94	Professional	26	$16.16	$25.38	$37.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.74 / $82.32 / $146.60	Professional	TC	$48.74	$82.32	$146.60
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.36 / $108.60 / $164.88	Professional		$0.36	$108.60	$164.88
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $23.52 / $31.36	Professional	26	$0.09	$23.52	$31.36
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.27 / $83.38 / $125.03	Professional	TC	$0.27	$83.38	$125.03
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.36 / $95.22 / $148.10	Professional		$0.36	$95.22	$148.10
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $19.60 / $29.40	Professional	26	$0.09	$19.60	$29.40
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.27 / $89.34 / $118.70	Professional	TC	$0.27	$89.34	$118.70
United Facility/Professional Professional Modifier Low / Median / High Price $70.95 / $94.55 / $172.08	Professional		$70.95	$94.55	$172.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.70 / $21.29 / $38.75	Professional	26	$16.70	$21.29	$38.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.48 / $73.26 / $128.44	Professional	TC	$50.48	$73.26	$128.44