Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.54 / $14.27 / $17.12	Facility	26	$13.54	$14.27	$17.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $43.82 / $118.66 / $479.29	Facility	TC	$43.82	$118.66	$479.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.17 / $59.56 / $280.00	Professional		$47.17	$59.56	$280.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.41 / $16.37 / $66.00	Professional	26	$13.41	$16.37	$66.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.81 / $41.21 / $204.00	Professional	TC	$31.81	$41.21	$204.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.84 / $51.25 / $79.50	Professional		$41.84	$51.25	$79.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $20.99 / $29.50	Professional	26	$10.80	$20.99	$29.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.70 / $57.68 / $80.97	Professional		$48.70	$57.68	$80.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $16.39 / $23.13	Professional	26	$12.28	$16.39	$23.13
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $65.76 / $74.73 / $97.93	Professional	50	$65.76	$74.73	$97.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.90 / $41.55 / $57.84	Professional	TC	$33.90	$41.55	$57.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.15 / $61.23 / $100.19	Professional		$39.15	$61.23	$100.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $18.41 / $26.47	Professional	26	$12.02	$18.41	$26.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.13 / $43.88 / $73.72	Professional	TC	$27.13	$43.88	$73.72
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.32 / $63.80 / $90.71	Professional		$0.32	$63.80	$90.71
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $17.39 / $23.25	Professional	26	$0.09	$17.39	$23.25
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.23 / $46.46 / $64.64	Professional	TC	$0.23	$46.46	$64.64
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.32 / $52.30 / $81.48	Professional		$0.32	$52.30	$81.48
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $13.92 / $20.88	Professional	26	$0.09	$13.92	$20.88
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.23 / $40.40 / $60.60	Professional	TC	$0.23	$40.40	$60.60
United Facility/Professional Professional Modifier Low / Median / High Price $38.94 / $52.69 / $87.23	Professional		$38.94	$52.69	$87.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.23 / $15.17 / $27.59	Professional	26	$12.23	$15.17	$27.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.71 / $37.53 / $67.68	Professional	TC	$26.71	$37.53	$67.68