Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.83 / $37.53 / $45.04	Facility	26	$34.83	$37.53	$45.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.66 / $91.23 / $499.00	Professional		$79.66	$91.23	$499.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.34 / $40.43 / $196.00	Professional	26	$33.34	$40.43	$196.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.65 / $51.14 / $93.08	Professional	TC	$45.65	$51.14	$93.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.34 / $78.29 / $114.13	Professional		$66.34	$78.29	$114.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.74 / $27.87 / $52.94	Professional	26	$27.74	$27.87	$52.94
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.08 / $44.08 / $44.08	Professional	TC	$44.08	$44.08	$44.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.37 / $93.80 / $126.46	Professional		$79.37	$93.80	$126.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.92 / $38.50 / $52.66	Professional	26	$34.92	$38.50	$52.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.45 / $52.25 / $73.13	Professional	TC	$44.45	$52.25	$73.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.56 / $111.71 / $161.71	Professional		$76.56	$111.71	$161.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.45 / $45.78 / $68.94	Professional	26	$29.45	$45.78	$68.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.78 / $63.87 / $97.30	Professional	TC	$44.78	$63.87	$97.30
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.81 / $105.08 / $157.63	Professional		$0.81	$105.08	$157.63
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.39 / $43.84 / $61.67	Professional	26	$0.39	$43.84	$61.67
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.42 / $61.25 / $89.32	Professional	TC	$0.42	$61.25	$89.32
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.81 / $82.93 / $131.36	Professional		$0.81	$82.93	$131.36
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.39 / $36.53 / $54.80	Professional	26	$0.39	$36.53	$54.80
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.42 / $51.04 / $79.40	Professional	TC	$0.42	$51.04	$79.40
United Facility/Professional Professional Modifier Low / Median / High Price $73.04 / $90.55 / $162.37	Professional		$73.04	$90.55	$162.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.57 / $39.34 / $64.91	Professional	26	$27.57	$39.34	$64.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.47 / $49.77 / $90.13	Professional	TC	$45.47	$49.77	$90.13