Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $15.85 / $19.95	Facility	26	$15.85	$15.85	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $45.71 / $93.33	Professional		$37.15	$45.71	$93.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $15.85 / $36.31	Professional	26	$12.88	$15.85	$36.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $29.51 / $56.23	Professional	TC	$22.91	$29.51	$56.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $35.48	Professional		$35.48	$35.48	$35.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $4.07 / $4.07 / $4.07	Professional	TC	$4.07	$4.07	$4.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $44.67 / $72.44	Professional		$42.66	$44.67	$72.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $15.49 / $26.30	Professional	26	$14.45	$15.49	$26.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $28.84 / $46.77	Professional	TC	$26.92	$28.84	$46.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $52.48 / $85.11	Professional		$35.48	$52.48	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $18.62 / $28.18	Professional	26	$13.80	$18.62	$28.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $34.67 / $56.23	Professional	TC	$21.88	$34.67	$56.23
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.44 / $56.23 / $75.86	Professional		$0.44	$56.23	$75.86
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.15 / $19.50 / $26.30	Professional	26	$0.15	$19.50	$26.30
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.28 / $37.15 / $50.12	Professional	TC	$0.28	$37.15	$50.12
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.44 / $0.44 / $70.79	Professional		$0.44	$0.44	$70.79
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.15 / $0.15 / $24.55	Professional	26	$0.15	$0.15	$24.55
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.28 / $0.28 / $46.77	Professional	TC	$0.28	$0.28	$46.77
Select Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $46.77 / $46.77	Professional		$44.67	$46.77	$46.77
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $16.22 / $16.22	Professional	26	$15.85	$16.22	$16.22
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $30.90 / $30.90	Professional	TC	$28.84	$30.90	$30.90
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $46.77 / $77.62	Professional		$36.31	$46.77	$77.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $17.78 / $28.84	Professional	26	$10.96	$17.78	$28.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $28.84 / $50.12	Professional	TC	$22.91	$28.84	$50.12