Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $25.12 / $30.90	Facility	26	$25.12	$25.12	$30.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $169.82 / $616.60	Professional		$95.50	$169.82	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $38.02 / $138.04	Professional	26	$22.91	$38.02	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $89.13 / $147.91	Professional	TC	$67.61	$89.13	$147.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $77.62 / $117.49	Professional		$67.61	$77.62	$117.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $23.44 / $39.81	Professional	26	$19.05	$23.44	$39.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $141.25 / $234.42	Professional		$97.72	$141.25	$234.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $37.15 / $58.88	Professional	26	$24.55	$37.15	$58.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $102.33 / $173.78	Professional	TC	$75.86	$102.33	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $134.90 / $190.55	Professional		$97.72	$134.90	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $35.48 / $50.12	Professional	26	$25.12	$35.48	$50.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $102.33 / $147.91	Professional	TC	$75.86	$102.33	$147.91
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.66 / $112.20 / $165.96	Professional		$1.66	$112.20	$165.96
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.65 / $26.92 / $40.74	Professional	26	$0.65	$26.92	$40.74
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.00 / $83.18 / $125.89	Professional	TC	$1.00	$83.18	$125.89
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.66 / $1.66 / $151.36	Professional		$1.66	$1.66	$151.36
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.65 / $0.65 / $37.15	Professional	26	$0.65	$0.65	$37.15
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $1.00 / $1.00 / $114.82	Professional	TC	$1.00	$1.00	$114.82
Select Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $100.00 / $134.90	Professional		$93.33	$100.00	$134.90
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $24.55 / $34.67	Professional	26	$23.44	$24.55	$34.67
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $75.86 / $100.00	Professional	TC	$70.79	$75.86	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $186.21	Professional		$95.50	$128.82	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $31.62 / $48.98	Professional	26	$23.44	$31.62	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $100.00 / $144.54	Professional	TC	$67.61	$100.00	$144.54