Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.29 / $147.91	Facility	26	$51.29	$51.29	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $218.78 / $630.96	Professional		$134.90	$218.78	$630.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $52.48 / $177.83	Professional	26	$43.65	$52.48	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $125.89 / $302.00	Professional	TC	$83.18	$125.89	$302.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $100.00 / $165.96	Professional		$87.10	$100.00	$165.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $52.48 / $79.43	Professional	26	$35.48	$52.48	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $58.88 / $134.90	Professional	TC	$58.88	$58.88	$134.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $53.70 / $91.20	Facility	26	$11.48	$53.70	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $199.53 / $416.87	Professional		$95.50	$199.53	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $57.54 / $107.15	Professional	26	$33.88	$57.54	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $141.25 / $309.03	Professional	TC	$67.61	$141.25	$309.03
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $56.23 / $56.23	Facility	26	$56.23	$56.23	$56.23
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $186.21 / $302.00	Professional		$93.33	$186.21	$302.00
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $53.70 / $75.86	Professional	26	$33.11	$53.70	$75.86
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $125.89 / $229.09	Professional	TC	$60.26	$125.89	$229.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $66.07 / $162.18	Professional		$32.36	$66.07	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $181.97 / $338.84	Professional		$123.03	$181.97	$338.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $46.77 / $89.13	Professional	26	$38.90	$46.77	$89.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $128.82 / $245.47	Professional	TC	$81.28	$128.82	$245.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $125.89	Professional		$100.00	$100.00	$125.89
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $35.48 / $46.77	Professional	26	$35.48	$35.48	$46.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $66.07 / $81.28	Professional	TC	$66.07	$66.07	$81.28