Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $12.59 / $15.14	Facility	26	$12.02	$12.59	$15.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $61.66 / $208.93	Professional		$43.65	$61.66	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.98 / $69.18	Professional	26	$10.96	$16.98	$69.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $42.66 / $87.10	Professional	TC	$32.36	$42.66	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $38.90 / $57.54	Professional		$33.11	$38.90	$57.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.23 / $20.42	Professional	26	$8.13	$10.23	$20.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $33.88 / $56.23	Professional	TC	$28.84	$33.88	$56.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $48.98 / $83.18	Professional		$46.77	$48.98	$83.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $11.75 / $20.42	Professional	26	$11.22	$11.75	$20.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $37.15 / $61.66	Professional	TC	$36.31	$37.15	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $60.26 / $100.00	Professional		$42.66	$60.26	$100.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $18.20 / $25.12	Professional	26	$12.30	$18.20	$25.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $43.65 / $75.86	Professional	TC	$30.20	$43.65	$75.86
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.41 / $64.57 / $85.11	Professional		$0.41	$64.57	$85.11
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.16 / $15.14 / $20.89	Professional	26	$0.16	$15.14	$20.89
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.24 / $48.98 / $64.57	Professional	TC	$0.24	$48.98	$64.57
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.41 / $0.41 / $79.43	Professional		$0.41	$0.41	$79.43
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.16 / $0.16 / $19.05	Professional	26	$0.16	$0.16	$19.05
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.24 / $0.24 / $61.66	Professional	TC	$0.24	$0.24	$61.66
Select Health Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $53.70 / $53.70	Professional		$50.12	$53.70	$53.70
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $12.59 / $12.59	Professional	26	$12.30	$12.59	$12.59
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $40.74 / $40.74	Professional	TC	$38.02	$40.74	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $52.48 / $85.11	Professional		$39.81	$52.48	$85.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $13.49 / $23.44	Professional	26	$10.72	$13.49	$23.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $35.48 / $61.66	Professional	TC	$29.51	$35.48	$61.66