Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $42.66 / $51.29	Facility	26	$42.66	$42.66	$51.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $89.13 / $190.55	Professional		$67.61	$89.13	$190.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $48.98 / $190.55	Professional	26	$38.02	$48.98	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $43.65 / $81.28	Professional	TC	$25.70	$43.65	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $85.11	Professional		$77.62	$77.62	$85.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $85.11 / $154.88	Professional		$58.88	$85.11	$154.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $50.12 / $77.62	Professional	26	$35.48	$50.12	$77.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $39.81 / $79.43	Professional	TC	$19.05	$39.81	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $89.13 / $151.36	Professional		$64.57	$89.13	$151.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $51.29 / $77.62	Professional	26	$38.90	$51.29	$77.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $38.02 / $79.43	Professional	TC	$22.39	$38.02	$79.43
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.63 / $66.07 / $131.83	Professional		$0.63	$66.07	$131.83
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.43 / $41.69 / $66.07	Professional	26	$0.43	$41.69	$66.07
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.20 / $25.12 / $66.07	Professional	TC	$0.20	$25.12	$66.07
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.63 / $0.63 / $123.03	Professional		$0.63	$0.63	$123.03
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.43 / $0.43 / $60.26	Professional	26	$0.43	$0.43	$60.26
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.20 / $0.20 / $63.10	Professional	TC	$0.20	$0.20	$63.10
Select Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $83.18 / $114.82	Professional		$79.43	$83.18	$114.82
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $40.74 / $57.54	Professional	26	$38.90	$40.74	$57.54
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $41.69 / $57.54	Professional	TC	$38.90	$41.69	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $93.33 / $147.91	Professional		$67.61	$93.33	$147.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $58.88 / $87.10	Professional	26	$39.81	$58.88	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $36.31 / $69.18	Professional	TC	$25.70	$36.31	$69.18