Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $59.00 / $204.45	Facility	26	$51.29	$59.00	$204.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $219.86 / $357.37	Professional		$171.00	$219.86	$357.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $60.94 / $154.35	Professional	26	$51.30	$60.94	$154.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $115.90 / $144.09 / $277.25	Professional	TC	$115.90	$144.09	$277.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.06 / $131.50 / $170.94	Professional		$115.06	$131.50	$170.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.79 / $50.96 / $123.31	Professional	26	$35.79	$50.96	$123.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $134.13 / $134.13 / $134.13	Professional	TC	$134.13	$134.13	$134.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $184.61	Facility	26	$69.05	$69.05	$184.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.77 / $247.64 / $493.91	Professional		$128.77	$247.64	$493.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.79 / $70.50 / $126.61	Professional	26	$42.79	$70.50	$126.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.70 / $169.42 / $382.63	Professional	TC	$85.70	$169.42	$382.63
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $67.58 / $67.58 / $67.58	Facility	26	$67.58	$67.58	$67.58
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $139.83 / $227.22 / $357.36	Professional		$139.83	$227.22	$357.36
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $47.31 / $70.12 / $88.70	Professional	26	$47.31	$70.12	$88.70
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $95.81 / $150.35 / $265.81	Professional	TC	$95.81	$150.35	$265.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $124.22 / $222.99	Professional		$41.40	$124.22	$222.99
United Facility/Professional Professional Modifier Low / Median / High Price $146.09 / $207.97 / $405.66	Professional		$146.09	$207.97	$405.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.80 / $54.83 / $118.77	Professional	26	$46.80	$54.83	$118.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.91 / $142.12 / $303.86	Professional	TC	$97.91	$142.12	$303.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $114.43 / $114.43 / $114.43	Professional		$114.43	$114.43	$114.43
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $38.36 / $38.36 / $38.36	Professional	26	$38.36	$38.36	$38.36
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $76.06 / $76.06 / $76.06	Professional	TC	$76.06	$76.06	$76.06