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 / $39.81	Facility	26	$33.11	$33.11	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $123.03 / $512.86	Professional		$63.10	$123.03	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $34.67 / $112.20	Professional	26	$25.12	$34.67	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $85.11 / $316.23	Professional	TC	$41.69	$85.11	$316.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $79.43 / $95.50	Professional		$67.61	$79.43	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $23.44 / $40.74	Professional	26	$20.42	$23.44	$40.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $97.72 / $173.78	Professional		$70.79	$97.72	$173.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $26.30 / $46.77	Professional	26	$25.70	$26.30	$46.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $70.79 / $125.89	Professional	TC	$44.67	$70.79	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $117.49 / $199.53	Professional		$75.86	$117.49	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $31.62 / $52.48	Professional	26	$20.42	$31.62	$52.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $83.18 / $144.54	Professional	TC	$53.70	$83.18	$144.54
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.24 / $120.23 / $158.49	Professional		$2.24	$120.23	$158.49
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $31.62 / $42.66	Professional	26	$0.63	$31.62	$42.66
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.62 / $87.10 / $117.49	Professional	TC	$1.62	$87.10	$117.49
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.24 / $2.24 / $147.91	Professional		$2.24	$2.24	$147.91
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.63 / $0.63 / $39.81	Professional	26	$0.63	$0.63	$39.81
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.62 / $1.62 / $109.65	Professional	TC	$1.62	$1.62	$109.65
Select Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $100.00 / $100.00	Professional		$97.72	$100.00	$100.00
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $26.30 / $26.30	Professional	26	$26.30	$26.30	$26.30
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $72.44 / $72.44	Professional	TC	$72.44	$72.44	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $97.72 / $158.49	Professional		$70.79	$97.72	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $25.12 / $47.86	Professional	26	$21.88	$25.12	$47.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $66.07 / $125.89	Professional	TC	$48.98	$66.07	$125.89