Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.36 / $16.47 / $64.23	Facility	26	$13.36	$16.47	$64.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.60 / $80.70 / $157.60	Professional		$61.60	$80.70	$157.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.36 / $18.19 / $35.53	Professional	26	$13.36	$18.19	$35.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.24 / $60.70 / $97.51	Professional	TC	$48.24	$60.70	$97.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.35 / $63.82 / $81.92	Professional		$58.35	$63.82	$81.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.92 / $15.50 / $31.77	Professional	26	$14.92	$15.50	$31.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.72 / $22.72 / $62.43	Facility	26	$22.72	$22.72	$62.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.82 / $90.95 / $178.50	Professional		$63.82	$90.95	$178.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.20 / $22.98 / $41.33	Professional	26	$14.20	$22.98	$41.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.06 / $69.28 / $141.97	Professional	TC	$47.06	$69.28	$141.97
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $21.47 / $21.47 / $21.47	Facility	26	$21.47	$21.47	$21.47
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $63.19 / $84.72 / $120.28	Professional		$63.19	$84.72	$120.28
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $14.54 / $22.03 / $28.18	Professional	26	$14.54	$22.03	$28.18
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $46.64 / $62.70 / $90.18	Professional	TC	$46.64	$62.70	$90.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.90 / $82.73 / $143.05	Professional		$48.90	$82.73	$143.05
United Facility/Professional Professional Modifier Low / Median / High Price $62.90 / $77.90 / $166.68	Professional		$62.90	$77.90	$166.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.94 / $18.28 / $37.49	Professional	26	$15.94	$18.28	$37.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.01 / $59.19 / $122.27	Professional	TC	$46.01	$59.19	$122.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $47.76 / $47.76 / $47.76	Professional		$47.76	$47.76	$47.76
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $9.52 / $9.52	Professional	26	$9.52	$9.52	$9.52
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $38.24 / $38.24 / $38.24	Professional	TC	$38.24	$38.24	$38.24