Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.05 / $28.10 / $33.72	Facility	26	$26.05	$28.10	$33.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.52 / $79.34 / $427.24	Professional		$54.52	$79.34	$427.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $28.24 / $157.00	Professional	26	$23.46	$28.24	$157.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $27.26 / $32.60 / $444.97	Professional	52	$27.26	$32.60	$444.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.00 / $55.88 / $285.98	Professional	TC	$28.00	$55.88	$285.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.61 / $100.61 / $107.12	Professional		$100.61	$100.61	$107.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.18 / $38.54 / $56.76	Professional	26	$20.18	$38.54	$56.76
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $10.95 / $55.20 / $85.24	Professional	52	$10.95	$55.20	$85.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.24 / $70.15 / $104.40	Professional		$55.24	$70.15	$104.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.64 / $26.03 / $38.01	Professional	26	$25.64	$26.03	$38.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.21 / $37.09 / $66.23	Professional	TC	$29.21	$37.09	$66.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.92 / $91.55 / $131.63	Professional		$60.92	$91.55	$131.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.74 / $34.07 / $50.80	Professional	26	$21.74	$34.07	$50.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.96 / $56.71 / $91.82	Professional	TC	$31.96	$56.71	$91.82
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.63 / $80.05 / $127.14	Professional		$0.63	$80.05	$127.14
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.27 / $31.64 / $46.45	Professional	26	$0.27	$31.64	$46.45
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.36 / $49.40 / $70.36	Professional	TC	$0.36	$49.40	$70.36
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.63 / $56.08 / $91.32	Professional		$0.63	$56.08	$91.32
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.27 / $27.51 / $41.27	Professional	26	$0.27	$27.51	$41.27
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.36 / $33.38 / $50.07	Professional	TC	$0.36	$33.38	$50.07
United Facility/Professional Professional Modifier Low / Median / High Price $63.37 / $80.48 / $132.79	Professional		$63.37	$80.48	$132.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.61 / $29.59 / $52.44	Professional	26	$19.61	$29.59	$52.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.34 / $50.89 / $92.62	Professional	TC	$36.34	$50.89	$92.62