Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $8.91 / $8.91	Facility	26	$8.91	$8.91	$8.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $67.61 / $263.03	Professional		$52.48	$67.61	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.96 / $40.74	Professional	26	$7.94	$10.96	$40.74
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $39.81 / $39.81 / $39.81	Professional	52	$39.81	$39.81	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $52.48 / $104.71	Professional	TC	$42.66	$52.48	$104.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $53.70 / $63.10	Professional		$45.71	$53.70	$63.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.12 / $14.45	Professional	26	$7.59	$9.12	$14.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $46.77 / $46.77	Professional	TC	$46.77	$46.77	$46.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $66.07 / $107.15	Professional		$46.77	$66.07	$107.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.77 / $16.22	Professional	26	$7.59	$9.77	$16.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $56.23 / $91.20	Professional	TC	$39.81	$56.23	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $102.33	Professional		$50.12	$64.57	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.00 / $15.49	Professional	26	$7.94	$10.00	$15.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $54.95 / $85.11	Professional	TC	$42.66	$54.95	$85.11
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.43 / $63.10 / $95.50	Professional		$0.43	$63.10	$95.50
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.10 / $9.33 / $13.80	Professional	26	$0.10	$9.33	$13.80
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.33 / $53.70 / $81.28	Professional	TC	$0.33	$53.70	$81.28
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.43 / $0.43 / $95.50	Professional		$0.43	$0.43	$95.50
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.10 / $0.10 / $13.80	Professional	26	$0.10	$0.10	$13.80
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.33 / $0.33 / $81.28	Professional	TC	$0.33	$0.33	$81.28
Select Health Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $63.10 / $100.00	Professional		$53.70	$63.10	$100.00
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $9.33 / $15.85	Professional	26	$8.32	$9.33	$15.85
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $53.70 / $83.18	Professional	TC	$45.71	$53.70	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $63.10 / $102.33	Professional		$47.86	$63.10	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.23 / $16.22	Professional	26	$7.76	$10.23	$16.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $53.70 / $87.10	Professional	TC	$41.69	$53.70	$87.10