Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $120.23 / $676.08	Facility	26	$51.29	$120.23	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $524.81	Professional		$169.82	$239.88	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $64.57 / $154.88	Professional	26	$51.29	$64.57	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $158.49 / $346.74	Professional	TC	$120.23	$158.49	$346.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $147.91 / $389.05	Professional		$60.26	$147.91	$389.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $56.23 / $100.00	Professional	26	$44.67	$56.23	$100.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	TC	$144.54	$144.54	$144.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $117.49	Facility	26	$14.45	$67.61	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $269.15 / $588.84	Professional		$138.04	$269.15	$588.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $70.79 / $134.90	Professional	26	$42.66	$70.79	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $190.55 / $426.58	Professional	TC	$93.33	$190.55	$426.58
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $67.61 / $67.61	Facility	26	$67.61	$67.61	$67.61
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $223.87 / $354.81	Professional		$131.83	$223.87	$354.81
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $63.10 / $89.13	Professional	26	$41.69	$63.10	$89.13
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $154.88 / $263.03	Professional	TC	$89.13	$154.88	$263.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $93.33 / $229.09	Professional		$32.36	$93.33	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $239.88 / $426.58	Professional		$158.49	$239.88	$426.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $57.54 / $109.65	Professional	26	$48.98	$57.54	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $169.82 / $331.13	Professional	TC	$107.15	$169.82	$331.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $177.83	Professional		$144.54	$144.54	$177.83
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $45.71 / $58.88	Professional	26	$45.71	$45.71	$58.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $97.72 / $120.23	Professional	TC	$97.72	$97.72	$120.23