Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $52.48 / $208.93	Facility	26	$51.29	$52.48	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $208.93 / $501.19	Professional		$151.36	$208.93	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $75.86 / $181.97	Professional	26	$51.29	$75.86	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $123.03 / $288.40	Professional	TC	$91.20	$123.03	$288.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $114.82 / $147.91	Professional		$89.13	$114.82	$147.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $70.79 / $100.00	Professional	26	$44.67	$70.79	$100.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $66.07 / $66.07	Professional	TC	$66.07	$66.07	$66.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $69.18 / $117.49	Facility	26	$14.79	$69.18	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $208.93 / $426.58	Professional		$112.20	$208.93	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $64.57 / $128.82	Professional	26	$43.65	$64.57	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $141.25 / $288.40	Professional	TC	$70.79	$141.25	$288.40
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 $104.71 / $199.53 / $281.84	Professional		$104.71	$199.53	$281.84
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $61.66 / $89.13	Professional	26	$41.69	$61.66	$89.13
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $128.82 / $194.98	Professional	TC	$64.57	$128.82	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $70.79 / $177.83	Professional		$32.36	$70.79	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $186.21 / $331.13	Professional		$128.82	$186.21	$331.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $56.23 / $107.15	Professional	26	$47.86	$56.23	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $123.03 / $223.87	Professional	TC	$77.62	$123.03	$223.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $144.54	Professional		$109.65	$109.65	$144.54
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $43.65 / $58.88	Professional	26	$43.65	$43.65	$58.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $67.61 / $87.10	Professional	TC	$67.61	$67.61	$87.10