Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.42 / $7.55 / $74.93	Facility	26	$6.42	$7.55	$74.93
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $34.20 / $149.97 / $379.33	Facility	TC	$34.20	$149.97	$379.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.41 / $48.88 / $165.00	Professional		$28.41	$48.88	$165.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.21 / $12.78 / $46.40	Professional	26	$6.21	$12.78	$46.40
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.67 / $19.78 / $102.92	Professional	52	$17.67	$19.78	$102.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $36.97 / $164.00	Professional	TC	$22.57	$36.97	$164.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.45 / $29.68 / $36.29	Professional		$28.45	$29.68	$36.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.14 / $9.50 / $13.99	Professional	26	$5.14	$9.50	$13.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.01 / $34.72 / $46.57	Professional		$31.01	$34.72	$46.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.68 / $7.17 / $9.10	Professional	26	$5.68	$7.17	$9.10
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.21 / $49.66 / $69.84	Professional	50	$42.21	$49.66	$69.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.84 / $28.88 / $38.71	Professional	TC	$23.84	$28.88	$38.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.95 / $39.42 / $70.23	Professional		$25.95	$39.42	$70.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.60 / $8.57 / $12.72	Professional	26	$5.60	$8.57	$12.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.41 / $31.63 / $57.53	Professional	TC	$19.41	$31.63	$57.53
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.19 / $46.18 / $65.70	Professional		$0.19	$46.18	$65.70
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.07 / $8.28 / $10.61	Professional	26	$0.07	$8.28	$10.61
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.12 / $37.43 / $52.34	Professional	TC	$0.12	$37.43	$52.34
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.19 / $37.10 / $59.01	Professional		$0.19	$37.10	$59.01
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.07 / $6.63 / $9.94	Professional	26	$0.07	$6.63	$9.94
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.12 / $32.71 / $49.07	Professional	TC	$0.12	$32.71	$49.07
United Facility/Professional Professional Modifier Low / Median / High Price $21.85 / $36.09 / $59.55	Professional		$21.85	$36.09	$59.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.26 / $7.22 / $12.16	Professional	26	$5.26	$7.22	$12.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.63 / $28.87 / $47.20	Professional	TC	$15.63	$28.87	$47.20