Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.99 / $14.03 / $15.59	Facility	26	$12.99	$14.03	$15.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.18 / $111.00 / $438.00	Professional		$74.18	$111.00	$438.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $12.99 / $65.04	Professional	26	$10.68	$12.99	$65.04
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.09 / $43.01 / $229.70	Professional	52	$37.09	$43.01	$229.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.89 / $104.06 / $131.53	Professional	TC	$63.89	$104.06	$131.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $118.50 / $118.50 / $118.50	Professional		$118.50	$118.50	$118.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $14.22 / $22.16	Professional	26	$9.31	$14.22	$22.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.52 / $84.79 / $137.25	Professional		$77.52	$84.79	$137.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.43 / $12.45 / $14.98	Professional	26	$11.43	$12.45	$14.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.40 / $72.33 / $123.37	Professional	TC	$62.40	$72.33	$123.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.81 / $117.90 / $174.04	Professional		$76.81	$117.90	$174.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.44 / $16.16 / $23.38	Professional	26	$11.44	$16.16	$23.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.00 / $102.28 / $151.87	Professional	TC	$63.00	$102.28	$151.87
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.80 / $99.96 / $145.78	Professional		$1.80	$99.96	$145.78
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.92 / $13.26 / $20.18	Professional	26	$0.92	$13.26	$20.18
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.68 / $86.12 / $121.17	Professional	TC	$0.68	$86.12	$121.17
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $1.80 / $79.00 / $124.95	Professional		$1.80	$79.00	$124.95
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $1.04 / $11.53 / $17.30	Professional	26	$1.04	$11.53	$17.30
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.77 / $71.77 / $107.66	Professional	TC	$0.77	$71.77	$107.66
United Facility/Professional Professional Modifier Low / Median / High Price $79.20 / $118.81 / $192.01	Professional		$79.20	$118.81	$192.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.30 / $15.41 / $24.48	Professional	26	$11.30	$15.41	$24.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.36 / $108.11 / $165.19	Professional	TC	$69.36	$108.11	$165.19