Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.30 / $154.75	Facility	26	$51.29	$51.30	$154.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.69 / $173.41 / $321.47	Professional		$131.69	$173.41	$321.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.49 / $51.92 / $171.85	Professional	26	$44.49	$51.92	$171.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.77 / $119.70 / $221.14	Professional	TC	$84.77	$119.70	$221.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.84 / $98.25 / $201.94	Professional		$78.84	$98.25	$201.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.57 / $48.44 / $97.36	Professional	26	$34.57	$48.44	$97.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $59.26 / $59.26 / $123.01	Professional	TC	$59.26	$59.26	$123.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $155.10	Facility	26	$54.02	$54.02	$155.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.25 / $205.64 / $411.00	Professional		$96.25	$205.64	$411.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.13 / $57.00 / $107.12	Professional	26	$33.13	$57.00	$107.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.79 / $153.91 / $312.91	Professional	TC	$65.79	$153.91	$312.91
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $56.84 / $56.84 / $56.84	Facility	26	$56.84	$56.84	$56.84
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $123.20 / $211.54 / $303.89	Professional		$123.20	$211.54	$303.89
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $39.79 / $59.11 / $74.59	Professional	26	$39.79	$59.11	$74.59
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $85.52 / $154.10 / $232.55	Professional	TC	$85.52	$154.10	$232.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $111.22 / $191.83	Professional		$37.20	$111.22	$191.83
United Facility/Professional Professional Modifier Low / Median / High Price $121.97 / $180.63 / $355.84	Professional		$121.97	$180.63	$355.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.67 / $46.01 / $90.18	Professional	26	$38.67	$46.01	$90.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.98 / $128.18 / $263.94	Professional	TC	$80.98	$128.18	$263.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $100.58 / $100.58 / $100.58	Professional		$100.58	$100.58	$100.58
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $35.20 / $35.20 / $35.20	Professional	26	$35.20	$35.20	$35.20
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $65.38 / $65.38 / $65.38	Professional	TC	$65.38	$65.38	$65.38