Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $48.98 / $87.10	Professional		$42.66	$48.98	$87.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $34.67 / $117.49	Professional	26	$26.92	$34.67	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $21.38 / $33.11	Professional	TC	$15.14	$21.38	$33.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $16.60 / $16.60	Professional	26	$16.60	$16.60	$16.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $28.18 / $69.18	Professional		$23.44	$28.18	$69.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $17.38 / $50.12	Professional	26	$15.14	$17.38	$50.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.32 / $10.96 / $19.95	Professional	TC	$8.32	$10.96	$19.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $25.12 / $46.77	Facility	26	$23.44	$25.12	$46.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $32.36 / $89.13	Professional		$27.54	$32.36	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $20.42 / $53.70	Professional	26	$16.60	$20.42	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $11.48 / $35.48	Professional	TC	$10.00	$11.48	$35.48
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $70.79 / $89.13	Professional		$12.88	$70.79	$89.13
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $42.66 / $53.70	Professional	26	$8.13	$42.66	$53.70
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.68 / $27.54 / $34.67	Professional	TC	$4.68	$27.54	$34.67
Select Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $53.70 / $93.33	Professional		$51.29	$53.70	$93.33
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $33.11 / $60.26	Professional	26	$32.36	$33.11	$60.26
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $20.89 / $33.11	Professional	TC	$19.05	$20.89	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $34.67 / $72.44	Professional		$31.62	$34.67	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $22.39 / $60.26	Professional	26	$20.42	$22.39	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $12.88 / $30.90	Professional	TC	$11.48	$12.88	$30.90