Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.79 / $43.79 / $63.43	Facility	26	$43.79	$43.79	$63.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $709.48 / $709.48 / $709.48	Professional		$709.48	$709.48	$709.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $257.12 / $257.12 / $257.12	Professional	26	$257.12	$257.12	$257.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $452.37 / $452.37 / $452.37	Professional	TC	$452.37	$452.37	$452.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.08 / $92.44 / $115.55	Professional		$89.08	$92.44	$115.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.95 / $95.42 / $95.42	Professional	26	$34.95	$95.42	$95.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $57.53 / $57.53 / $57.53	Professional	TC	$57.53	$57.53	$57.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.66 / $149.47 / $194.21	Professional		$113.66	$149.47	$194.21
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.11 / $41.59 / $52.81	Professional	26	$34.11	$41.59	$52.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.06 / $115.35 / $123.14	Professional	TC	$72.06	$115.35	$123.14
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $2.58 / $138.66 / $202.21	Professional		$2.58	$138.66	$202.21
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.43 / $52.55 / $76.63	Professional	26	$0.43	$52.55	$76.63
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.86 / $91.91 / $125.58	Professional	TC	$0.86	$91.91	$125.58
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.30 / $115.55 / $173.33	Professional		$1.30	$115.55	$173.33
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.43 / $43.79 / $65.69	Professional	26	$0.43	$43.79	$65.69
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.86 / $71.76 / $107.64	Professional	TC	$0.86	$71.76	$107.64
United Facility/Professional Professional Modifier Low / Median / High Price $104.46 / $139.91 / $236.99	Professional		$104.46	$139.91	$236.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.71 / $46.19 / $85.45	Professional	26	$34.71	$46.19	$85.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.55 / $96.30 / $177.17	Professional	TC	$65.55	$96.30	$177.17