Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $22.91 / $27.54	Facility	26	$22.91	$22.91	$27.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $69.18 / $199.53	Professional		$28.84	$69.18	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $38.90 / $123.03	Professional	26	$18.20	$38.90	$123.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $60.26 / $199.53	Professional	50	$36.31	$60.26	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.91 / $26.92 / $72.44	Professional	TC	$8.91	$26.92	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $51.29 / $67.61	Professional		$41.69	$51.29	$67.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $25.70 / $47.86	Professional	26	$24.55	$25.70	$47.86
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $79.43 / $79.43 / $79.43	Professional	50	$79.43	$79.43	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $23.44 / $26.92	Professional	TC	$21.38	$23.44	$26.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $52.48 / $87.10	Professional		$26.30	$52.48	$87.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $21.38 / $38.02	Professional	26	$16.98	$21.38	$38.02
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $72.44 / $97.72 / $107.15	Professional	50	$72.44	$97.72	$107.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.12 / $31.62 / $47.86	Professional	TC	$9.12	$31.62	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $58.88 / $114.82	Professional		$29.51	$58.88	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $29.51 / $61.66	Professional	26	$19.50	$29.51	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.33 / $30.20 / $58.88	Professional	TC	$9.33	$30.20	$58.88
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.26 / $50.12 / $102.33	Professional		$0.26	$50.12	$102.33
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.17 / $38.02 / $54.95	Professional	26	$0.17	$38.02	$54.95
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.09 / $38.02 / $54.95	Professional	TC	$0.09	$38.02	$54.95
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.26 / $46.77 / $95.50	Professional		$0.26	$46.77	$95.50
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.17 / $46.77 / $47.86	Professional	26	$0.17	$46.77	$47.86
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.09 / $46.77 / $47.86	Professional	TC	$0.09	$46.77	$47.86
Select Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $64.57 / $67.61	Professional		$58.88	$64.57	$67.61
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $31.62 / $45.71	Professional	26	$30.90	$31.62	$45.71
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $32.36 / $33.11	Professional	TC	$14.45	$32.36	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $54.95 / $83.18	Professional		$25.12	$54.95	$83.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $25.12 / $38.90	Professional	26	$16.60	$25.12	$38.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.51 / $26.92 / $40.74	Professional	TC	$8.51	$26.92	$40.74