Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $67.61 / $87.10	Professional		$42.66	$67.61	$87.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $26.92 / $35.48	Professional	26	$19.05	$26.92	$35.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $37.15 / $60.26	Professional	TC	$28.18	$37.15	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $61.66 / $63.10	Professional		$54.95	$61.66	$63.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $33.11 / $33.88	Professional	TC	$33.11	$33.11	$33.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $69.18 / $102.33	Professional		$53.70	$69.18	$102.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $28.18 / $43.65	Professional	26	$18.20	$28.18	$43.65
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $117.49 / $117.49 / $117.49	Professional	50	$117.49	$117.49	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $39.81 / $61.66	Professional	TC	$32.36	$39.81	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $72.44 / $117.49	Professional		$50.12	$72.44	$117.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $28.18 / $37.15	Professional	26	$21.38	$28.18	$37.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $42.66 / $70.79	Professional	TC	$26.30	$42.66	$70.79
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.10 / $75.86 / $107.15	Professional		$1.10	$75.86	$107.15
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.50 / $31.62 / $43.65	Professional	26	$0.50	$31.62	$43.65
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.59 / $44.67 / $60.26	Professional	TC	$0.59	$44.67	$60.26
Select Health Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $63.10 / $95.50	Professional		$60.26	$63.10	$95.50
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $26.30 / $40.74	Professional	26	$25.70	$26.30	$40.74
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $37.15 / $52.48	Professional	TC	$33.88	$37.15	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $72.44 / $112.20	Professional		$53.70	$72.44	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $27.54 / $47.86	Professional	26	$21.88	$27.54	$47.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $48.98 / $69.18	Professional	TC	$30.90	$48.98	$69.18