Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $46.77 / $57.54	Facility	26	$46.77	$46.77	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $234.42 / $776.25	Professional		$123.03	$234.42	$776.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $83.18 / $245.47	Professional	26	$41.69	$83.18	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $102.33 / $194.98	Professional	TC	$74.13	$102.33	$194.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $114.82 / $223.87	Professional		$87.10	$114.82	$223.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $38.02 / $51.29	Professional	26	$32.36	$38.02	$51.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $52.48 / $66.07	Professional	TC	$48.98	$52.48	$66.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $154.88 / $229.09	Professional		$128.82	$154.88	$229.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $52.48 / $77.62	Professional	26	$44.67	$52.48	$77.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $100.00 / $147.91	Professional	TC	$83.18	$100.00	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $173.78 / $263.03	Professional		$125.89	$173.78	$263.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $63.10 / $91.20	Professional	26	$39.81	$63.10	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $117.49 / $173.78	Professional	TC	$81.28	$117.49	$173.78
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.05 / $162.18 / $223.87	Professional		$1.05	$162.18	$223.87
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.50 / $56.23 / $77.62	Professional	26	$0.50	$56.23	$77.62
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $107.15 / $147.91	Professional	TC	$54.95	$107.15	$147.91
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.05 / $1.05 / $204.17	Professional		$1.05	$1.05	$204.17
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.50 / $0.50 / $69.18	Professional	26	$0.50	$0.50	$69.18
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $89.13 / $131.83	Professional	TC	$89.13	$89.13	$131.83
Select Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $134.90 / $186.21	Professional		$128.82	$134.90	$186.21
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $46.77 / $67.61	Professional	26	$45.71	$46.77	$67.61
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $89.13 / $117.49	Professional	TC	$85.11	$89.13	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $144.54 / $229.09	Professional		$107.15	$144.54	$229.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $51.29 / $75.86	Professional	26	$34.67	$51.29	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $91.20 / $147.91	Professional	TC	$72.44	$91.20	$147.91