Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $18.20 / $21.88	Facility	26	$18.20	$18.20	$21.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $87.10 / $281.84	Professional		$50.12	$87.10	$281.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $30.90 / $85.11	Professional	26	$16.60	$30.90	$85.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $42.66 / $112.20	Professional	TC	$30.90	$42.66	$112.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $39.81 / $51.29	Professional		$34.67	$39.81	$51.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.79 / $20.89	Professional	26	$12.02	$14.79	$20.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $87.10 / $134.90	Professional		$51.29	$87.10	$134.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $26.30 / $43.65	Professional	26	$17.38	$26.30	$43.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $57.54 / $91.20	Professional	TC	$34.67	$57.54	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $81.28 / $120.23	Professional		$53.70	$81.28	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $25.70 / $36.31	Professional	26	$18.20	$25.70	$36.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $56.23 / $91.20	Professional	TC	$35.48	$56.23	$91.20
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.12 / $56.23 / $85.11	Professional		$1.12	$56.23	$85.11
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.25 / $19.50 / $28.18	Professional	26	$0.25	$19.50	$28.18
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.87 / $35.48 / $54.95	Professional	TC	$0.87	$35.48	$54.95
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.12 / $1.12 / $77.62	Professional		$1.12	$1.12	$77.62
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.25 / $0.25 / $25.70	Professional	26	$0.25	$0.25	$25.70
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.87 / $0.87 / $51.29	Professional	TC	$0.87	$0.87	$51.29
Select Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $51.29 / $69.18	Professional		$48.98	$51.29	$69.18
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $17.38 / $25.12	Professional	26	$16.60	$17.38	$25.12
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $33.88 / $44.67	Professional	TC	$31.62	$33.88	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $81.28 / $123.03	Professional		$48.98	$81.28	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $22.39 / $34.67	Professional	26	$16.98	$22.39	$34.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $53.70 / $89.13	Professional	TC	$31.62	$53.70	$89.13