Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.84 / $13.25 / $15.90	Facility	26	$12.84	$13.25	$15.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.29 / $62.67 / $283.00	Professional		$48.29	$62.67	$283.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.78 / $13.90 / $76.09	Professional	26	$12.78	$13.90	$76.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.14 / $46.11 / $205.00	Professional	TC	$34.14	$46.11	$205.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.10 / $45.10 / $57.50	Professional		$45.10	$45.10	$57.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.27 / $10.27 / $18.29	Professional	26	$10.27	$10.27	$18.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.69 / $61.77 / $86.12	Professional		$52.69	$61.77	$86.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.43 / $15.22 / $21.66	Professional	26	$11.43	$15.22	$21.66
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $72.53 / $82.43 / $108.99	Professional	50	$72.53	$82.43	$108.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.94 / $48.36 / $65.59	Professional	TC	$38.94	$48.36	$65.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.49 / $65.80 / $110.15	Professional		$41.49	$65.80	$110.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $17.37 / $24.60	Professional	26	$11.48	$17.37	$24.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.01 / $49.92 / $85.56	Professional	TC	$30.01	$49.92	$85.56
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.32 / $72.08 / $104.68	Professional		$0.32	$72.08	$104.68
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $16.55 / $22.13	Professional	26	$0.09	$16.55	$22.13
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.23 / $56.84 / $79.09	Professional	TC	$0.23	$56.84	$79.09
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.32 / $58.72 / $94.02	Professional		$0.32	$58.72	$94.02
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $13.25 / $19.88	Professional	26	$0.09	$13.25	$19.88
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.23 / $49.43 / $74.15	Professional	TC	$0.23	$49.43	$74.15
United Facility/Professional Professional Modifier Low / Median / High Price $43.31 / $56.66 / $104.05	Professional		$43.31	$56.66	$104.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.66 / $14.44 / $26.51	Professional	26	$11.66	$14.44	$26.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.55 / $42.59 / $77.51	Professional	TC	$29.55	$42.59	$77.51