Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $37.15 / $45.71	Facility	26	$37.15	$37.15	$45.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $77.62 / $194.98	Professional		$64.57	$77.62	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $44.67 / $100.00	Professional	26	$33.11	$44.67	$100.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $37.15 / $69.18	Professional	TC	$21.88	$37.15	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $66.07 / $102.33	Professional		$61.66	$66.07	$102.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $31.62 / $44.67	Professional	26	$30.90	$31.62	$44.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $72.44 / $134.90	Professional		$52.48	$72.44	$134.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $46.77 / $75.86	Professional	26	$31.62	$46.77	$75.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $33.88 / $66.07	Professional	TC	$16.22	$33.88	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $77.62 / $131.83	Professional		$56.23	$77.62	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $44.67 / $72.44	Professional	26	$35.48	$44.67	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $32.36 / $66.07	Professional	TC	$19.50	$32.36	$66.07
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.52 / $63.10 / $112.20	Professional		$0.52	$63.10	$112.20
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.35 / $38.90 / $57.54	Professional	26	$0.35	$38.90	$57.54
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.18 / $21.38 / $56.23	Professional	TC	$0.18	$21.38	$56.23
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.52 / $0.52 / $107.15	Professional		$0.52	$0.52	$107.15
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.35 / $0.35 / $52.48	Professional	26	$0.35	$0.35	$52.48
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.18 / $0.18 / $53.70	Professional	TC	$0.18	$0.18	$53.70
Select Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $70.79 / $97.72	Professional		$67.61	$70.79	$97.72
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $35.48 / $50.12	Professional	26	$33.88	$35.48	$50.12
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $35.48 / $47.86	Professional	TC	$32.36	$35.48	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $81.28 / $128.82	Professional		$58.88	$81.28	$128.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $51.29 / $77.62	Professional	26	$35.48	$51.29	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.90 / $58.88	Professional	TC	$21.88	$30.90	$58.88