Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $10.72 / $13.18	Facility	26	$10.00	$10.72	$13.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $46.77 / $204.17	Professional		$33.11	$46.77	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.22 / $31.62	Professional	26	$8.91	$11.22	$31.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $33.11 / $64.57	Professional	TC	$23.99	$33.11	$64.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $32.36 / $39.81	Professional		$30.20	$32.36	$39.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.51 / $17.38	Professional	26	$7.94	$8.51	$17.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $23.99 / $39.81	Professional	TC	$21.88	$23.99	$39.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $67.61	Professional		$38.90	$38.90	$67.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $10.47 / $17.78	Professional	26	$10.23	$10.47	$17.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $28.84 / $50.12	Professional	TC	$28.84	$28.84	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $52.48 / $79.43	Professional		$34.67	$52.48	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.49 / $19.95	Professional	26	$9.77	$13.49	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $38.90 / $58.88	Professional	TC	$25.12	$38.90	$58.88
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.34 / $50.12 / $69.18	Professional		$0.34	$50.12	$69.18
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.12 / $12.88 / $16.98	Professional	26	$0.12	$12.88	$16.98
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.23 / $38.02 / $51.29	Professional	TC	$0.23	$38.02	$51.29
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.34 / $0.34 / $63.10	Professional		$0.34	$0.34	$63.10
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.12 / $0.12 / $15.85	Professional	26	$0.12	$0.12	$15.85
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.23 / $0.23 / $46.77	Professional	TC	$0.23	$0.23	$46.77
Select Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $41.69 / $41.69	Professional		$39.81	$41.69	$41.69
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $10.72 / $10.72	Professional	26	$10.23	$10.72	$10.72
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $31.62 / $31.62	Professional	TC	$28.84	$31.62	$31.62
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $43.65 / $67.61	Professional		$36.31	$43.65	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $11.48 / $19.05	Professional	26	$7.59	$11.48	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $28.84 / $52.48	Professional	TC	$26.92	$28.84	$52.48