Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $14.13 / $17.38	Facility	26	$14.13	$14.13	$17.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $54.95 / $234.42	Professional		$43.65	$54.95	$234.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.13 / $30.20	Professional	26	$12.02	$14.13	$30.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $40.74 / $77.62	Professional	TC	$30.90	$40.74	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $83.18	Professional		$41.69	$41.69	$83.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $11.75 / $11.75	Professional	26	$11.75	$11.75	$11.75
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $15.85 / $15.85	Professional	TC	$15.85	$15.85	$15.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $50.12 / $104.71	Professional		$47.86	$50.12	$104.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $13.80 / $25.70	Professional	26	$13.80	$13.80	$25.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $36.31 / $77.62	Professional	TC	$34.67	$36.31	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $61.66 / $91.20	Professional		$43.65	$61.66	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $16.60 / $26.30	Professional	26	$12.02	$16.60	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $45.71 / $75.86	Professional	TC	$33.11	$45.71	$75.86
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.05 / $66.07 / $87.10	Professional		$1.05	$66.07	$87.10
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.18 / $16.98 / $22.91	Professional	26	$0.18	$16.98	$22.91
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.85 / $47.86 / $64.57	Professional	TC	$0.85	$47.86	$64.57
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.05 / $1.05 / $81.28	Professional		$1.05	$1.05	$81.28
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.18 / $0.18 / $21.38	Professional	26	$0.18	$0.18	$21.38
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.85 / $0.85 / $60.26	Professional	TC	$0.85	$0.85	$60.26
Select Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $53.70 / $53.70	Professional		$52.48	$53.70	$53.70
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $14.13 / $14.13	Professional	26	$13.49	$14.13	$14.13
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $39.81 / $39.81	Professional	TC	$38.02	$39.81	$39.81
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $51.29 / $89.13	Professional		$39.81	$51.29	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $12.02 / $25.12	Professional	26	$10.96	$12.02	$25.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $33.88 / $67.61	Professional	TC	$28.18	$33.88	$67.61