Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $25.70 / $25.70	Facility	26	$25.70	$25.70	$25.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $114.82 / $223.87	Professional		$87.10	$114.82	$223.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $30.20 / $81.28	Professional	26	$23.44	$30.20	$81.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $87.10 / $165.96	Professional	TC	$63.10	$87.10	$165.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $58.88	Professional		$57.54	$57.54	$58.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $19.95 / $43.65	Professional	26	$15.49	$19.95	$43.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $61.66	Professional	TC	$44.67	$44.67	$61.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $151.36	Professional		$53.70	$53.70	$151.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $14.79 / $38.90	Professional	26	$14.79	$14.79	$38.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $38.90 / $112.20	Professional	TC	$38.90	$38.90	$112.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $24.55 / $44.67	Facility	26	$22.91	$24.55	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $70.79 / $218.78	Professional		$48.98	$70.79	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $17.38 / $53.70	Professional	26	$13.18	$17.38	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $52.48 / $162.18	Professional	TC	$35.48	$52.48	$162.18
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $158.49 / $208.93	Professional		$25.12	$158.49	$208.93
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $39.81 / $52.48	Professional	26	$6.92	$39.81	$52.48
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $120.23 / $158.49	Professional	TC	$18.62	$120.23	$158.49
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $25.12	Professional		$25.12	$25.12	$25.12
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $6.92 / $47.86	Professional	26	$6.92	$6.92	$47.86
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $18.62 / $141.25	Professional	TC	$18.62	$18.62	$141.25
Select Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $31.62 / $31.62	Professional	26	$31.62	$31.62	$31.62
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	TC	$95.50	$95.50	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $85.11 / $173.78	Professional		$61.66	$85.11	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $21.88 / $45.71	Professional	26	$17.38	$21.88	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $63.10 / $131.83	Professional	TC	$44.67	$63.10	$131.83