Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $33.11 / $40.74	Facility	26	$33.11	$33.11	$40.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $85.11 / $331.13	Professional		$67.61	$85.11	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $34.67 / $104.71	Professional	26	$28.18	$34.67	$104.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $50.12 / $89.13	Professional	TC	$39.81	$50.12	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $29.51 / $69.18	Professional	26	$25.12	$29.51	$69.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $81.28 / $141.25	Professional		$79.43	$81.28	$141.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $31.62 / $54.95	Professional	26	$31.62	$31.62	$54.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $48.98 / $85.11	Professional	TC	$46.77	$48.98	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $95.50 / $147.91	Professional		$66.07	$95.50	$147.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $39.81 / $61.66	Professional	26	$27.54	$39.81	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $54.95 / $91.20	Professional	TC	$38.02	$54.95	$91.20
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $102.33 / $131.83	Professional		$79.43	$102.33	$131.83
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $41.69 / $52.48	Professional	26	$31.62	$41.69	$52.48
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $61.66 / $77.62	Professional	TC	$46.77	$61.66	$77.62
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $47.86 / $47.86	Professional	26	$47.86	$47.86	$47.86
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $70.79 / $70.79	Professional	TC	$70.79	$70.79	$70.79
Select Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Professional		$79.43	$79.43	$79.43
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $31.62 / $31.62	Professional	26	$31.62	$31.62	$31.62
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $47.86 / $47.86	Professional	TC	$46.77	$47.86	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $83.18 / $138.04	Professional		$66.07	$83.18	$138.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $35.48 / $58.88	Professional	26	$28.18	$35.48	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $47.86 / $83.18	Professional	TC	$38.02	$47.86	$83.18