Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $10.96 / $112.20	Facility	26	$10.00	$10.96	$112.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $42.66 / $257.04 / $933.25	Facility	TC	$42.66	$257.04	$933.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $57.54 / $194.98	Professional		$28.18	$57.54	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $17.78 / $61.66	Professional	26	$8.91	$17.78	$61.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.69 / $123.03 / $380.19	Professional	50	$41.69	$123.03	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $42.66 / $114.82	Professional	TC	$28.18	$42.66	$114.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $36.31 / $52.48	Professional		$30.90	$36.31	$52.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $8.91 / $18.20	Professional	26	$8.13	$8.91	$18.20
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $45.71 / $56.23 / $60.26	Professional	50	$45.71	$56.23	$60.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $41.69 / $64.57	Professional	TC	$28.84	$41.69	$64.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $43.65 / $74.13	Professional		$42.66	$43.65	$74.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $10.23 / $17.78	Professional	26	$9.77	$10.23	$17.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $51.29 / $64.57 / $85.11	Professional	50	$51.29	$64.57	$85.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $33.88 / $54.95	Professional	TC	$30.20	$33.88	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $47.86 / $79.43	Professional		$34.67	$47.86	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.49 / $21.38	Professional	26	$9.77	$13.49	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $36.31 / $69.18	Professional	TC	$25.12	$36.31	$69.18
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.27 / $58.88 / $79.43	Professional		$0.27	$58.88	$79.43
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.11 / $13.18 / $17.38	Professional	26	$0.11	$13.18	$17.38
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $45.71 / $61.66	Professional	TC	$0.16	$45.71	$61.66
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.27 / $0.27 / $74.13	Professional		$0.27	$0.27	$74.13
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.11 / $0.11 / $16.60	Professional	26	$0.11	$0.11	$16.60
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.16 / $0.16 / $57.54	Professional	TC	$0.16	$0.16	$57.54
Select Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $48.98 / $48.98	Professional		$45.71	$48.98	$48.98
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $10.96 / $10.96	Professional	26	$10.72	$10.96	$10.96
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $38.02 / $38.02	Professional	TC	$35.48	$38.02	$38.02
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $44.67 / $72.44	Professional		$29.51	$44.67	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.48 / $19.05	Professional	26	$7.76	$11.48	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $33.11 / $53.70	Professional	TC	$20.89	$33.11	$53.70