Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $15.14 / $18.20	Facility	26	$15.14	$15.14	$18.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $52.48 / $75.86	Professional		$42.66	$52.48	$75.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $15.14 / $23.99	Professional	26	$12.88	$15.14	$23.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $36.31 / $53.70	Professional	TC	$28.84	$36.31	$53.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $54.95 / $91.20	Professional		$44.67	$54.95	$91.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $16.60 / $26.92	Professional	26	$12.59	$16.60	$26.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $39.81 / $64.57	Professional	TC	$31.62	$39.81	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $61.66 / $93.33	Professional		$45.71	$61.66	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $17.38 / $26.30	Professional	26	$13.49	$17.38	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $43.65 / $66.07	Professional	TC	$30.90	$43.65	$66.07
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.50 / $43.65 / $64.57	Professional		$0.50	$43.65	$64.57
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.10 / $13.80 / $21.88	Professional	26	$0.10	$13.80	$21.88
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.40 / $29.51 / $43.65	Professional	TC	$0.40	$29.51	$43.65
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.50 / $0.50 / $60.26	Professional		$0.50	$0.50	$60.26
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.10 / $0.10 / $19.95	Professional	26	$0.10	$0.10	$19.95
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.40 / $0.40 / $39.81	Professional	TC	$0.40	$0.40	$39.81
Select Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $57.54	Professional		$39.81	$39.81	$57.54
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $13.18 / $19.50	Professional	26	$13.18	$13.18	$19.50
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $26.30 / $38.02	Professional	TC	$26.30	$26.30	$38.02
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $64.57 / $100.00	Professional		$45.71	$64.57	$100.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $19.95 / $30.20	Professional	26	$14.13	$19.95	$30.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $47.86 / $74.13	Professional	TC	$31.62	$47.86	$74.13