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 / $18.20	Facility	26	$18.20	$18.20	$18.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $72.44 / $346.74	Professional		$53.70	$72.44	$346.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $19.95 / $177.83	Professional	26	$15.85	$19.95	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $45.71 / $77.62	Professional	TC	$37.15	$45.71	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $61.66 / $67.61	Professional		$54.95	$61.66	$67.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $16.98 / $22.39	Professional	26	$15.85	$16.98	$22.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $112.20	Professional		$50.12	$70.79	$112.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $20.42 / $32.36	Professional	26	$16.22	$20.42	$32.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $50.12 / $79.43	Professional	TC	$34.67	$50.12	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $114.82	Professional		$57.54	$75.86	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $22.39 / $34.67	Professional	26	$16.98	$22.39	$34.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $53.70 / $81.28	Professional	TC	$39.81	$53.70	$81.28
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.45 / $70.79 / $100.00	Professional		$0.45	$70.79	$100.00
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.15 / $19.95 / $28.18	Professional	26	$0.15	$19.95	$28.18
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.30 / $51.29 / $70.79	Professional	TC	$0.30	$51.29	$70.79
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.45 / $0.45 / $97.72	Professional		$0.45	$0.45	$97.72
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.15 / $0.15 / $27.54	Professional	26	$0.15	$0.15	$27.54
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.30 / $0.30 / $69.18	Professional	TC	$0.30	$0.30	$69.18
Select Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $64.57 / $112.20	Professional		$57.54	$64.57	$112.20
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $18.20 / $33.88	Professional	26	$17.38	$18.20	$33.88
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $45.71 / $77.62	Professional	TC	$40.74	$45.71	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $72.44 / $104.71	Professional		$52.48	$72.44	$104.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $23.44 / $32.36	Professional	26	$16.60	$23.44	$32.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $51.29 / $77.62	Professional	TC	$38.02	$51.29	$77.62