Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.22 / $33.33 / $41.20	Facility	26	$30.22	$33.33	$41.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.31 / $103.70 / $449.15	Professional		$55.31	$103.70	$449.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $33.33 / $159.00	Professional	26	$24.78	$33.33	$159.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.87 / $75.20 / $98.28	Professional	TC	$10.87	$75.20	$98.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.20 / $41.20 / $41.20	Professional		$41.20	$41.20	$41.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.24 / $63.70 / $138.80	Professional		$55.24	$63.70	$138.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.16 / $28.25 / $35.82	Professional	26	$24.16	$28.25	$35.82
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $73.09 / $85.99 / $191.28	Professional	50	$73.09	$85.99	$191.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.98 / $32.59 / $105.62	Professional	TC	$26.98	$32.59	$105.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.15 / $103.74 / $171.87	Professional		$55.15	$103.74	$171.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.83 / $36.72 / $63.60	Professional	26	$24.83	$36.72	$63.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.57 / $78.70 / $127.32	Professional	TC	$12.57	$78.70	$127.32
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $37.22 / $65.34 / $137.34	Professional		$37.22	$65.34	$137.34
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.81 / $49.63 / $72.38	Professional	26	$23.81	$49.63	$72.38
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $10.09 / $19.22 / $84.19	Professional	TC	$10.09	$19.22	$84.19
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.00 / $51.50 / $80.28	Professional		$1.00	$51.50	$80.28
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.25 / $41.36 / $63.81	Professional	26	$0.25	$41.36	$63.81
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.75 / $16.82 / $62.04	Professional	TC	$0.75	$16.82	$62.04
United Facility/Professional Professional Modifier Low / Median / High Price $64.31 / $96.34 / $164.54	Professional		$64.31	$96.34	$164.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $32.13 / $60.52	Professional	26	$25.70	$32.13	$60.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.39 / $64.34 / $120.80	Professional	TC	$27.39	$64.34	$120.80