Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $55.93 / $137.91	Facility	26	$51.29	$55.93	$137.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.31 / $174.47 / $378.00	Professional		$128.31	$174.47	$378.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.93 / $51.30 / $125.41	Professional	26	$39.93	$51.30	$125.41
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $63.69 / $85.50 / $137.50	Professional	52	$63.69	$85.50	$137.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.96 / $119.70 / $231.46	Professional	TC	$88.96	$119.70	$231.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.19 / $96.87 / $198.46	Professional		$77.19	$96.87	$198.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.78 / $40.98 / $83.83	Professional	26	$29.78	$40.98	$83.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.27 / $46.27 / $124.55	Facility	26	$46.27	$46.27	$124.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.04 / $190.00 / $381.21	Professional		$94.04	$190.00	$381.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.67 / $55.79 / $95.44	Professional	26	$28.67	$55.79	$95.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.84 / $135.75 / $282.11	Professional	TC	$65.84	$135.75	$282.11
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $45.38 / $45.38 / $45.38	Facility	26	$45.38	$45.38	$45.38
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $105.09 / $164.88 / $255.24	Professional		$105.09	$164.88	$255.24
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $48.78 / $66.84	Professional	26	$31.76	$48.78	$66.84
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $72.18 / $113.25 / $191.25	Professional	TC	$72.18	$113.25	$191.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $111.13 / $191.55	Professional		$36.17	$111.13	$191.55
United Facility/Professional Professional Modifier Low / Median / High Price $109.17 / $163.05 / $318.56	Professional		$109.17	$163.05	$318.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.19 / $44.03 / $82.78	Professional	26	$34.19	$44.03	$82.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.87 / $116.44 / $224.35	Professional	TC	$73.87	$116.44	$224.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.74 / $89.74 / $89.74	Professional		$89.74	$89.74	$89.74
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.33 / $27.33 / $27.33	Professional	26	$27.33	$27.33	$27.33
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $62.41 / $62.41 / $62.41	Professional	TC	$62.41	$62.41	$62.41