Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.29 / $190.55	Facility	26	$51.29	$51.29	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $257.04 / $602.56	Professional		$169.82	$257.04	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $79.43 / $208.93	Professional	26	$51.29	$79.43	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $186.21 / $389.05	Professional	TC	$120.23	$186.21	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $128.82	Professional		$120.23	$120.23	$128.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $61.66 / $93.33	Professional	26	$39.81	$61.66	$93.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $60.26 / $104.71	Facility	26	$13.18	$60.26	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $269.15 / $562.34	Professional		$134.90	$269.15	$562.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $67.61 / $131.83	Professional	26	$38.02	$67.61	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $199.53 / $426.58	Professional	TC	$104.71	$199.53	$426.58
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Facility	26	$72.44	$72.44	$72.44
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $257.04 / $389.05	Professional		$128.82	$257.04	$389.05
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $64.57 / $95.50	Professional	26	$37.15	$64.57	$95.50
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $190.55 / $295.12	Professional	TC	$91.20	$190.55	$295.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $83.18 / $229.09	Professional		$32.36	$83.18	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $251.19 / $446.68	Professional		$173.78	$251.19	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $57.54 / $104.71	Professional	26	$45.71	$57.54	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $190.55 / $338.84	Professional	TC	$128.82	$190.55	$338.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $173.78	Professional		$141.25	$141.25	$173.78
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $40.74 / $52.48	Professional	26	$40.74	$40.74	$52.48
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $100.00 / $123.03	Professional	TC	$100.00	$100.00	$123.03