Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $30.20 / $30.20	Facility	26	$30.20	$30.20	$30.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $54.95 / $257.04	Professional		$44.67	$54.95	$257.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $28.84 / $61.66	Professional	26	$22.91	$28.84	$61.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $23.99 / $114.82	Professional	TC	$18.20	$23.99	$114.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $33.11 / $36.31	Professional		$29.51	$33.11	$36.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $22.91 / $44.67	Professional	26	$21.38	$22.91	$44.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $10.72 / $13.49	Professional	TC	$10.72	$10.72	$13.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $50.12 / $87.10	Professional		$48.98	$50.12	$87.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $27.54 / $47.86	Professional	26	$27.54	$27.54	$47.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $22.39 / $38.90	Professional	TC	$22.39	$22.39	$38.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Professional		$38.90	$38.90	$38.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $25.12 / $26.30	Professional	26	$25.12	$25.12	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $14.13 / $22.39	Professional	TC	$14.13	$14.13	$22.39
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $47.86 / $66.07	Professional		$0.60	$47.86	$66.07
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.35 / $31.62 / $43.65	Professional	26	$0.35	$31.62	$43.65
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.25 / $16.60 / $24.55	Professional	TC	$0.25	$16.60	$24.55
Hometown Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $0.60 / $60.26	Professional		$0.60	$0.60	$60.26
Hometown Health Facility/Professional Professional Modifier 26 Low / Median / High Price $0.35 / $0.35 / $41.69	Professional	26	$0.35	$0.35	$41.69
Hometown Health Facility/Professional Professional Modifier TC Low / Median / High Price $0.25 / $0.25 / $19.05	Professional	TC	$0.25	$0.25	$19.05
Select Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $42.66	Professional		$39.81	$39.81	$42.66
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $27.54 / $27.54	Professional	26	$27.54	$27.54	$27.54
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $12.59 / $15.14	Professional	TC	$12.59	$12.59	$15.14
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $61.66 / $87.10	Professional		$43.65	$61.66	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $33.88 / $50.12	Professional	26	$24.55	$33.88	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $27.54 / $41.69	Professional	TC	$18.62	$27.54	$41.69