Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $26.92 / $33.11	Facility	26	$26.92	$26.92	$33.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $125.89 / $199.53	Professional		$91.20	$125.89	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $26.92 / $45.71	Professional	26	$21.88	$26.92	$45.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $100.00 / $199.53	Professional	TC	$72.44	$100.00	$199.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $89.13 / $134.90	Professional		$75.86	$89.13	$134.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $20.89 / $43.65	Professional	26	$20.42	$20.89	$43.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $125.89 / $204.17	Professional		$97.72	$125.89	$204.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $25.12 / $43.65	Professional	26	$25.12	$25.12	$43.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $100.00 / $151.36	Professional	TC	$70.79	$100.00	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $134.90 / $229.09	Professional		$91.20	$134.90	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $32.36 / $50.12	Professional	26	$22.39	$32.36	$50.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $104.71 / $194.98	Professional	TC	$70.79	$104.71	$194.98
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.85 / $162.18 / $213.80	Professional		$0.85	$162.18	$213.80
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.32 / $31.62 / $42.66	Professional	26	$0.32	$31.62	$42.66
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.54 / $128.82 / $173.78	Professional	TC	$0.54	$128.82	$173.78
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.85 / $0.85 / $199.53	Professional		$0.85	$0.85	$199.53
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.32 / $0.32 / $39.81	Professional	26	$0.32	$0.32	$39.81
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.54 / $0.54 / $162.18	Professional	TC	$0.54	$0.54	$162.18
Select Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $134.90 / $134.90	Professional		$125.89	$134.90	$134.90
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $26.30 / $26.30	Professional	26	$25.70	$26.30	$26.30
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $107.15 / $107.15	Professional	TC	$100.00	$107.15	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $199.53	Professional		$81.28	$123.03	$199.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $28.18 / $46.77	Professional	26	$19.50	$28.18	$46.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $93.33 / $154.88	Professional	TC	$63.10	$93.33	$154.88