Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $12.88 / $16.22	Facility	26	$12.88	$12.88	$16.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $45.71 / $125.89	Professional		$36.31	$45.71	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.45 / $41.69	Professional	26	$10.96	$14.45	$41.69
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	52	$144.54	$144.54	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $30.90 / $57.54	Professional	TC	$22.39	$30.90	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $35.48 / $38.90	Professional		$30.20	$35.48	$38.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $10.00 / $20.89	Professional	26	$9.77	$10.00	$20.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $48.98 / $67.61	Professional	TC	$48.98	$48.98	$67.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $42.66 / $70.79	Professional		$39.81	$42.66	$70.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $12.30 / $21.38	Professional	26	$12.30	$12.30	$21.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $30.20 / $50.12	Professional	TC	$24.55	$30.20	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $46.77 / $83.18	Professional		$33.11	$46.77	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $15.14 / $23.44	Professional	26	$11.48	$15.14	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $32.36 / $54.95	Professional	TC	$21.38	$32.36	$54.95
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.34 / $54.95 / $74.13	Professional		$0.34	$54.95	$74.13
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.14 / $15.49 / $21.38	Professional	26	$0.14	$15.49	$21.38
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.21 / $39.81 / $53.70	Professional	TC	$0.21	$39.81	$53.70
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.34 / $0.34 / $69.18	Professional		$0.34	$0.34	$69.18
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.14 / $0.14 / $19.50	Professional	26	$0.14	$0.14	$19.50
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.21 / $0.21 / $50.12	Professional	TC	$0.21	$0.21	$50.12
Select Health Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $46.77 / $46.77	Professional		$43.65	$46.77	$46.77
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $12.88 / $12.88	Professional	26	$12.59	$12.88	$12.88
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $33.11 / $33.11	Professional	TC	$31.62	$33.11	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $44.67 / $72.44	Professional		$30.90	$44.67	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $14.13 / $22.91	Professional	26	$10.00	$14.13	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.90 / $50.12	Professional	TC	$20.89	$30.90	$50.12