Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.08 / $47.30 / $56.76	Facility	26	$45.08	$47.30	$56.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.29 / $139.30 / $595.00	Professional		$112.29	$139.30	$595.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.60 / $63.13 / $247.50	Professional	26	$42.60	$63.13	$247.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.70 / $79.00 / $156.18	Professional	TC	$67.70	$79.00	$156.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.11 / $116.91 / $197.12	Professional		$90.11	$116.91	$197.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.07 / $44.44 / $88.62	Professional	26	$36.07	$44.44	$88.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $61.67 / $61.67 / $61.67	Professional	TC	$61.67	$61.67	$61.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.76 / $123.20 / $171.82	Professional		$111.76	$123.20	$171.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.13 / $48.65 / $66.55	Professional	26	$44.13	$48.65	$66.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.62 / $75.20 / $105.95	Professional	TC	$67.62	$75.20	$105.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.18 / $151.35 / $220.67	Professional		$105.18	$151.35	$220.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.49 / $59.63 / $87.77	Professional	26	$39.49	$59.63	$87.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.90 / $90.33 / $135.11	Professional	TC	$53.90	$90.33	$135.11
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.72 / $139.97 / $204.14	Professional		$0.72	$139.97	$204.14
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.23 / $55.39 / $77.93	Professional	26	$0.23	$55.39	$77.93
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $84.59 / $119.01	Professional	TC	$44.67	$84.59	$119.01
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.72 / $112.64 / $174.98	Professional		$0.72	$112.64	$174.98
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.23 / $46.16 / $69.23	Professional	26	$0.23	$46.16	$69.23
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.50 / $70.48 / $105.74	Professional	TC	$0.50	$70.48	$105.74
United Facility/Professional Professional Modifier Low / Median / High Price $98.90 / $124.70 / $221.57	Professional		$98.90	$124.70	$221.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.96 / $50.89 / $83.20	Professional	26	$34.96	$50.89	$83.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.94 / $73.76 / $135.19	Professional	TC	$63.94	$73.76	$135.19