Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $48.98 / $60.26	Facility	26	$48.98	$48.98	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $104.71 / $501.19	Professional		$87.10	$104.71	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $52.48 / $239.88	Professional	26	$42.66	$52.48	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $47.86 / $89.13	Professional	TC	$40.74	$47.86	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $38.02 / $40.74	Professional	26	$38.02	$38.02	$40.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $89.13 / $177.83	Professional		$87.10	$89.13	$177.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $46.77 / $93.33	Professional	26	$46.77	$46.77	$93.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $47.86 / $83.18	Professional	TC	$40.74	$47.86	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $158.49 / $239.88	Professional		$93.33	$158.49	$239.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $58.88 / $97.72	Professional	26	$43.65	$58.88	$97.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $87.10 / $151.36	Professional	TC	$44.67	$87.10	$151.36
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.41 / $114.82 / $158.49	Professional		$1.41	$114.82	$158.49
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.48 / $60.26 / $83.18	Professional	26	$0.48	$60.26	$83.18
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $57.54 / $79.43	Professional	TC	$34.67	$57.54	$79.43
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.41 / $1.41 / $141.25	Professional		$1.41	$1.41	$141.25
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.48 / $0.48 / $74.13	Professional	26	$0.48	$0.48	$74.13
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $67.61 / $70.79	Professional	TC	$67.61	$67.61	$70.79
Select Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $50.12 / $50.12	Professional	26	$48.98	$50.12	$50.12
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $44.67 / $44.67	Professional	TC	$43.65	$44.67	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $123.03 / $204.17	Professional		$97.72	$123.03	$204.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $61.66 / $97.72	Professional	26	$33.88	$61.66	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $67.61 / $134.90	Professional	TC	$44.67	$67.61	$134.90