Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $52.48 / $104.71	Professional		$29.51	$52.48	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.18 / $52.48	Professional	26	$8.91	$13.18	$52.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $42.66 / $58.88	Professional	TC	$21.38	$42.66	$58.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $25.70 / $165.96	Professional		$20.42	$25.70	$165.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.13 / $5.37 / $33.11	Professional	26	$5.13	$5.37	$33.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $24.55 / $54.95	Professional		$21.88	$24.55	$54.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.90 / $5.62 / $27.54	Professional	26	$4.90	$5.62	$27.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $19.05 / $20.42	Professional	TC	$16.22	$19.05	$20.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $29.51 / $54.95	Facility		$27.54	$29.51	$54.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $8.13 / $14.79	Facility	26	$7.59	$8.13	$14.79
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $19.95 / $21.38 / $39.81	Facility	TC	$19.95	$21.38	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $32.36 / $70.79	Professional		$20.42	$32.36	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.37 / $6.76 / $17.78	Professional	26	$5.37	$6.76	$17.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $26.92 / $53.70	Professional	TC	$15.49	$26.92	$53.70
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $53.70 / $66.07	Professional		$10.47	$53.70	$66.07
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $2.57 / $13.49 / $16.98	Professional	26	$2.57	$13.49	$16.98
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $7.94 / $39.81 / $50.12	Professional	TC	$7.94	$39.81	$50.12
Select Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $40.74 / $69.18	Professional		$38.02	$40.74	$69.18
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $10.23 / $19.05	Professional	26	$10.00	$10.23	$19.05
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $30.90 / $51.29	Professional	TC	$28.18	$30.90	$51.29
United Facility/Professional Facility Modifier Low / Median / High Price $6.17 / $20.89 / $75.86	Facility		$6.17	$20.89	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $36.31 / $74.13	Professional		$25.12	$36.31	$74.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $7.08 / $30.20	Professional	26	$6.46	$7.08	$30.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $30.20 / $52.48	Professional	TC	$17.78	$30.20	$52.48