Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $10.00 / $13.18	Facility	26	$10.00	$10.00	$13.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $41.69 / $144.54	Professional		$31.62	$41.69	$144.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $42.66	Professional	26	$7.94	$12.02	$42.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.20 / $64.57	Professional	TC	$21.88	$30.20	$64.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $31.62 / $48.98	Professional		$26.30	$31.62	$48.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $7.94 / $16.60	Professional	26	$7.08	$7.94	$16.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $26.30 / $47.86	Professional	TC	$22.91	$26.30	$47.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $37.15 / $61.66	Professional		$36.31	$37.15	$61.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $10.23 / $17.38	Professional	26	$9.55	$10.23	$17.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $26.92 / $43.65	Professional	TC	$25.70	$26.92	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $42.66 / $74.13	Professional		$29.51	$42.66	$74.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $19.05	Professional	26	$7.94	$12.02	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $29.51 / $54.95	Professional	TC	$20.89	$29.51	$54.95
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.28 / $46.77 / $61.66	Professional		$0.28	$46.77	$61.66
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.13 / $12.30 / $16.60	Professional	26	$0.13	$12.30	$16.60
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $33.88 / $45.71	Professional	TC	$0.16	$33.88	$45.71
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.28 / $0.28 / $57.54	Professional		$0.28	$0.28	$57.54
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.13 / $0.13 / $15.49	Professional	26	$0.13	$0.13	$15.49
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $0.16 / $42.66	Professional	TC	$0.16	$0.16	$42.66
Select Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $38.90 / $38.90	Professional		$38.02	$38.90	$38.90
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $10.23 / $10.23	Professional	26	$10.23	$10.23	$10.23
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $28.18 / $28.18	Professional	TC	$27.54	$28.18	$28.18
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $38.90 / $63.10	Professional		$26.30	$38.90	$63.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $11.75 / $17.78	Professional	26	$6.76	$11.75	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $26.92 / $43.65	Professional	TC	$19.50	$26.92	$43.65