Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $19.95 / $24.55	Facility	26	$19.95	$19.95	$24.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $100.00 / $186.21	Professional		$74.13	$100.00	$186.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $20.89 / $44.67	Professional	26	$16.98	$20.89	$44.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $75.86 / $128.82	Professional	TC	$54.95	$75.86	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $97.72	Professional		$79.43	$79.43	$97.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $15.49 / $31.62	Professional	26	$15.14	$15.49	$31.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $154.88	Professional		$93.33	$93.33	$154.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $19.05 / $33.11	Professional	26	$18.62	$19.05	$33.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $74.13 / $123.03	Professional	TC	$74.13	$74.13	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $186.21	Professional		$69.18	$102.33	$186.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $23.44 / $38.02	Professional	26	$16.22	$23.44	$38.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $81.28 / $147.91	Professional	TC	$52.48	$81.28	$147.91
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.36 / $117.49 / $158.49	Professional		$0.36	$117.49	$158.49
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $23.44 / $31.62	Professional	26	$0.09	$23.44	$31.62
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $95.50 / $125.89	Professional	TC	$47.86	$95.50	$125.89
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.36 / $0.36 / $147.91	Professional		$0.36	$0.36	$147.91
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $0.09 / $29.51	Professional	26	$0.09	$0.09	$29.51
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $89.13 / $117.49	Professional	TC	$89.13	$89.13	$117.49
Select Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $97.72 / $97.72	Professional		$95.50	$97.72	$97.72
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.50 / $19.50	Professional	26	$19.50	$19.50	$19.50
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $79.43 / $79.43	Professional	TC	$75.86	$79.43	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $95.50 / $151.36	Professional		$64.57	$95.50	$151.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $21.38 / $34.67	Professional	26	$16.60	$21.38	$34.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $72.44 / $120.23	Professional	TC	$47.86	$72.44	$120.23