Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.46 / $14.94 / $17.93	Facility	26	$14.46	$14.94	$17.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.85 / $68.58 / $306.00	Professional		$54.85	$68.58	$306.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $17.26 / $88.00	Professional	26	$14.36	$17.26	$88.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.11 / $46.78 / $174.40	Professional	TC	$37.11	$46.78	$174.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.36 / $46.13 / $113.00	Professional		$40.36	$46.13	$113.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $21.98 / $31.51	Professional	26	$11.70	$21.98	$31.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $55.54 / $55.54 / $55.54	Professional	TC	$55.54	$55.54	$55.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.98 / $67.50 / $94.41	Professional		$55.98	$67.50	$94.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.82 / $17.61 / $24.32	Professional	26	$12.82	$17.61	$24.32
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.16 / $48.82 / $69.59	Professional	TC	$41.16	$48.82	$69.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.46 / $70.36 / $114.53	Professional		$45.46	$70.36	$114.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.86 / $19.57 / $27.72	Professional	26	$12.86	$19.57	$27.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.60 / $51.57 / $86.80	Professional	TC	$32.60	$51.57	$86.80
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.36 / $73.61 / $102.44	Professional		$0.36	$73.61	$102.44
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $18.44 / $24.37	Professional	26	$0.09	$18.44	$24.37
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.27 / $53.76 / $74.80	Professional	TC	$0.27	$53.76	$74.80
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.36 / $60.01 / $92.01	Professional		$0.36	$60.01	$92.01
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.09 / $14.59 / $21.89	Professional	26	$0.09	$14.59	$21.89
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.27 / $46.75 / $70.13	Professional	TC	$0.27	$46.75	$70.13
United Facility/Professional Professional Modifier Low / Median / High Price $47.50 / $59.91 / $104.58	Professional		$47.50	$59.91	$104.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.07 / $16.25 / $29.56	Professional	26	$13.07	$16.25	$29.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.75 / $43.67 / $79.48	Professional	TC	$33.75	$43.67	$79.48