Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $14.13 / $17.78	Facility	26	$14.13	$14.13	$17.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $46.77 / $97.72	Professional		$33.11	$46.77	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.49 / $36.31	Professional	26	$12.02	$15.49	$36.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.18 / $53.70	Professional	TC	$20.89	$28.18	$53.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $33.88 / $33.88	Professional		$33.88	$33.88	$33.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $2.95 / $11.75 / $12.59	Professional	26	$2.95	$11.75	$12.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $38.02 / $83.18	Professional		$33.88	$38.02	$83.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $14.13 / $23.99	Professional	26	$12.59	$14.13	$23.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $24.55 / $66.07	Professional	TC	$19.95	$24.55	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $58.88 / $91.20	Professional		$34.67	$58.88	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $19.05 / $28.18	Professional	26	$12.59	$19.05	$28.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $39.81 / $72.44	Professional	TC	$22.39	$39.81	$72.44
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.45 / $50.12 / $67.61	Professional		$0.45	$50.12	$67.61
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.18 / $17.78 / $23.99	Professional	26	$0.18	$17.78	$23.99
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.27 / $32.36 / $43.65	Professional	TC	$0.27	$32.36	$43.65
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.45 / $0.45 / $63.10	Professional		$0.45	$0.45	$63.10
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.18 / $0.18 / $22.39	Professional	26	$0.18	$0.18	$22.39
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.27 / $0.27 / $39.81	Professional	TC	$0.27	$0.27	$39.81
Select Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $41.69 / $41.69	Professional		$39.81	$41.69	$41.69
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $14.79 / $14.79	Professional	26	$14.45	$14.79	$14.79
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $26.92 / $26.92	Professional	TC	$25.70	$26.92	$26.92
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $52.48 / $79.43	Professional		$38.02	$52.48	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $16.22 / $26.92	Professional	26	$11.75	$16.22	$26.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.20 / $60.26	Professional	TC	$21.88	$30.20	$60.26