Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $10.96 / $13.49	Facility	26	$10.96	$10.96	$13.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $95.50 / $436.52	Facility	TC	$25.70	$95.50	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $38.90 / $181.97	Professional		$28.84	$38.90	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.88 / $61.66	Professional	26	$8.91	$12.88	$61.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $26.92 / $57.54	Professional	TC	$19.95	$26.92	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $27.54 / $33.11	Professional		$22.39	$27.54	$33.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $8.91 / $16.22	Professional	26	$8.32	$8.91	$16.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $23.99 / $46.77	Professional	TC	$16.22	$23.99	$46.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $34.67 / $60.26	Professional		$29.51	$34.67	$60.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $10.47 / $18.20	Professional	26	$9.33	$10.47	$18.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $24.55 / $40.74	Professional	TC	$19.95	$24.55	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $39.81 / $69.18	Professional		$26.92	$39.81	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $13.18 / $20.89	Professional	26	$9.12	$13.18	$20.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $26.92 / $48.98	Professional	TC	$18.62	$26.92	$48.98
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.26 / $43.65 / $57.54	Professional		$0.26	$43.65	$57.54
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.11 / $12.88 / $16.98	Professional	26	$0.11	$12.88	$16.98
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.15 / $30.20 / $40.74	Professional	TC	$0.15	$30.20	$40.74
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.26 / $0.26 / $53.70	Professional		$0.26	$0.26	$53.70
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.11 / $0.11 / $15.85	Professional	26	$0.11	$0.11	$15.85
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.15 / $0.15 / $38.02	Professional	TC	$0.15	$0.15	$38.02
Select Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $36.31 / $36.31	Professional		$35.48	$36.31	$36.31
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $10.72 / $10.72	Professional	26	$10.72	$10.72	$10.72
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $25.12 / $25.12	Professional	TC	$25.12	$25.12	$25.12
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $36.31 / $60.26	Professional		$26.92	$36.31	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.02 / $19.50	Professional	26	$9.33	$12.02	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $24.55 / $39.81	Professional	TC	$17.38	$24.55	$39.81