Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $81.28 / $109.65	Professional		$52.48	$81.28	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $48.98 / $117.49	Professional	26	$25.70	$48.98	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $46.77 / $61.66	Professional	TC	$30.90	$46.77	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $33.11 / $40.74	Professional		$33.11	$33.11	$40.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.22 / $79.43	Professional	26	$12.88	$16.22	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $25.12 / $25.12	Professional	TC	$25.12	$25.12	$25.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $40.74 / $144.54	Professional		$34.67	$40.74	$144.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $22.39 / $97.72	Professional	26	$13.49	$22.39	$97.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $20.89 / $83.18	Professional	TC	$18.62	$20.89	$83.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $46.77 / $87.10	Facility		$44.67	$46.77	$87.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $19.50 / $36.31	Facility	26	$18.20	$19.50	$36.31
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.30 / $27.54 / $51.29	Facility	TC	$26.30	$27.54	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $53.70 / $107.15	Professional		$33.11	$53.70	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $32.36 / $45.71	Professional	26	$12.88	$32.36	$45.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $24.55 / $66.07	Professional	TC	$19.95	$24.55	$66.07
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $85.11 / $107.15	Professional		$25.70	$85.11	$107.15
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $33.88 / $42.66	Professional	26	$13.49	$33.88	$42.66
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $51.29 / $64.57	Professional	TC	$12.30	$51.29	$64.57
Select Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $66.07 / $112.20	Professional		$61.66	$66.07	$112.20
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $25.70 / $46.77	Professional	26	$25.12	$25.70	$46.77
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $39.81 / $64.57	Professional	TC	$36.31	$39.81	$64.57
United Facility/Professional Facility Modifier Low / Median / High Price $14.45 / $19.95 / $46.77	Facility		$14.45	$19.95	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $63.10 / $125.89	Professional		$40.74	$63.10	$125.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $28.84 / $64.57	Professional	26	$16.98	$28.84	$64.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $27.54 / $63.10	Professional	TC	$23.99	$27.54	$63.10