Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.46 / $13.91 / $56.66	Facility	26	$11.46	$13.91	$56.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.91 / $65.68 / $111.10	Professional		$49.91	$65.68	$111.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.46 / $15.61 / $26.40	Professional	26	$11.46	$15.61	$26.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.45 / $49.52 / $76.89	Professional	TC	$38.45	$49.52	$76.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.91 / $59.33 / $166.86	Professional		$51.91	$59.33	$166.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.97 / $20.54 / $30.97	Professional	26	$12.97	$20.54	$30.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $19.60 / $52.98	Facility	26	$19.60	$19.60	$52.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.86 / $76.97 / $146.88	Professional		$52.86	$76.97	$146.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.99 / $19.71 / $35.15	Professional	26	$11.99	$19.71	$35.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.08 / $56.89 / $112.00	Professional	TC	$39.08	$56.89	$112.00
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $18.57 / $18.57 / $18.57	Facility	26	$18.57	$18.57	$18.57
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $51.92 / $71.47 / $101.06	Professional		$51.92	$71.47	$101.06
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $12.27 / $19.14 / $24.38	Professional	26	$12.27	$19.14	$24.38
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $38.95 / $52.34 / $75.30	Professional	TC	$38.95	$52.34	$75.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.48 / $66.92 / $112.43	Professional		$41.48	$66.92	$112.43
United Facility/Professional Professional Modifier Low / Median / High Price $52.68 / $64.84 / $134.85	Professional		$52.68	$64.84	$134.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.63 / $15.61 / $33.02	Professional	26	$13.63	$15.61	$33.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.15 / $49.32 / $97.58	Professional	TC	$38.15	$49.32	$97.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.20 / $40.20 / $40.20	Professional		$40.20	$40.20	$40.20
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.58 / $8.58 / $8.58	Professional	26	$8.58	$8.58	$8.58
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $31.63 / $31.63 / $31.63	Professional	TC	$31.63	$31.63	$31.63