Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $54.48 / $187.74	Facility	26	$51.29	$54.48	$187.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.88 / $172.30 / $367.64	Professional		$133.88	$172.30	$367.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.89 / $54.53 / $174.89	Professional	26	$46.89	$54.53	$174.89
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $66.72 / $85.50 / $137.50	Professional	52	$66.72	$85.50	$137.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.12 / $119.70 / $231.46	Professional	TC	$84.12	$119.70	$231.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.81 / $101.01 / $170.45	Professional		$80.81	$101.01	$170.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.39 / $48.62 / $115.46	Professional	26	$37.39	$48.62	$115.46
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $61.68 / $71.78 / $197.37	Professional	TC	$61.68	$71.78	$197.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.64 / $58.64 / $169.53	Facility	26	$58.64	$58.64	$169.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.25 / $200.62 / $412.48	Professional		$99.25	$200.62	$412.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.38 / $59.51 / $111.12	Professional	26	$36.38	$59.51	$111.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.46 / $141.75 / $312.08	Professional	TC	$62.46	$141.75	$312.08
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $54.31 / $54.31 / $54.31	Facility	26	$54.31	$54.31	$54.31
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $126.26 / $210.63 / $303.89	Professional		$126.26	$210.63	$303.89
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $58.39 / $71.28	Professional	26	$38.02	$58.39	$71.28
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $84.52 / $152.02 / $231.69	Professional	TC	$84.52	$152.02	$231.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.81 / $111.39 / $191.55	Professional		$38.81	$111.39	$191.55
United Facility/Professional Professional Modifier Low / Median / High Price $124.13 / $178.12 / $356.49	Professional		$124.13	$178.12	$356.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.09 / $48.62 / $98.46	Professional	26	$40.09	$48.62	$98.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.88 / $122.78 / $249.59	Professional	TC	$76.88	$122.78	$249.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.50 / $97.50 / $97.50	Professional		$97.50	$97.50	$97.50
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $36.24 / $36.24 / $36.24	Professional	26	$36.24	$36.24	$36.24
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $61.27 / $61.27 / $61.27	Professional	TC	$61.27	$61.27	$61.27