Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $28.18 / $33.88	Facility	26	$28.18	$28.18	$33.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $91.20 / $489.78	Professional		$52.48	$91.20	$489.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $37.15 / $151.36	Professional	26	$22.91	$37.15	$151.36
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $44.67 / $114.82 / $489.78	Professional	52	$44.67	$114.82	$489.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $50.12 / $104.71	Professional	TC	$25.70	$50.12	$104.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $45.71 / $77.62	Professional		$38.02	$45.71	$77.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $21.38 / $44.67	Professional	26	$6.03	$21.38	$44.67
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $5.62 / $38.02 / $93.33	Professional	52	$5.62	$38.02	$93.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $22.39 / $22.91	Professional	TC	$22.39	$22.39	$22.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $109.65	Professional		$54.95	$70.79	$109.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $26.30 / $44.67	Professional	26	$25.70	$26.30	$44.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $37.15 / $69.18	Professional	TC	$29.51	$37.15	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $95.50 / $141.25	Professional		$66.07	$95.50	$141.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $34.67 / $52.48	Professional	26	$21.88	$34.67	$52.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $58.88 / $91.20	Professional	TC	$38.02	$58.88	$91.20
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.63 / $72.44 / $107.15	Professional		$0.63	$72.44	$107.15
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.27 / $31.62 / $45.71	Professional	26	$0.27	$31.62	$45.71
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.36 / $39.81 / $66.07	Professional	TC	$0.36	$39.81	$66.07
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.63 / $0.63 / $91.20	Professional		$0.63	$0.63	$91.20
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.27 / $0.27 / $41.69	Professional	26	$0.27	$0.27	$41.69
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.36 / $0.36 / $50.12	Professional	TC	$0.36	$0.36	$50.12
Select Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $60.26 / $81.28	Professional		$56.23	$60.26	$81.28
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $27.54 / $38.90	Professional	26	$26.30	$27.54	$38.90
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $33.11 / $46.77	Professional	TC	$30.20	$33.11	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $81.28 / $125.89	Professional		$57.54	$81.28	$125.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $29.51 / $41.69	Professional	26	$19.50	$29.51	$41.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $51.29 / $87.10	Professional	TC	$29.51	$51.29	$87.10