Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $13.49 / $67.61	Facility	26	$12.88	$13.49	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $100.00 / $229.09	Professional		$61.66	$100.00	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $22.91 / $56.23	Professional	26	$13.80	$22.91	$56.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $67.61 / $154.88	Professional	TC	$47.86	$67.61	$154.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $77.62 / $120.23	Professional		$60.26	$77.62	$120.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $20.89 / $31.62	Professional	26	$15.49	$20.89	$31.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.90 / $22.91 / $38.90	Facility	26	$4.90	$22.91	$38.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $89.13 / $177.83	Professional		$63.10	$89.13	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $21.88 / $44.67	Professional	26	$14.13	$21.88	$44.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $67.61 / $147.91	Professional	TC	$45.71	$67.61	$147.91
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $21.38 / $21.38 / $21.38	Facility	26	$21.38	$21.38	$21.38
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $75.86 / $120.23	Professional		$61.66	$75.86	$120.23
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $18.62 / $28.18	Professional	26	$13.80	$18.62	$28.18
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $58.88 / $91.20	Professional	TC	$44.67	$58.88	$91.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $33.11 / $89.13	Professional		$22.91	$33.11	$89.13
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $77.62 / $144.54	Professional		$61.66	$77.62	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $18.62 / $34.67	Professional	26	$15.85	$18.62	$34.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $58.88 / $109.65	Professional	TC	$45.71	$58.88	$109.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $95.50	Professional		$52.48	$52.48	$95.50
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $10.72 / $19.50	Professional	26	$10.72	$10.72	$19.50
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $41.69 / $75.86	Professional	TC	$41.69	$41.69	$75.86