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 $131.83 / $199.53 / $537.03	Professional		$131.83	$199.53	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $57.54 / $177.83	Professional	26	$43.65	$57.54	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $120.23 / $295.12	Professional	TC	$83.18	$120.23	$295.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $93.33 / $125.89	Professional		$75.86	$93.33	$125.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $45.71 / $79.43	Professional	26	$34.67	$45.71	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	TC	$97.72	$97.72	$97.72
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 $33.11 / $57.54 / $107.15	Professional	26	$33.11	$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 $53.70 / $53.70 / $53.70	Facility	26	$53.70	$53.70	$53.70
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $181.97 / $295.12	Professional		$93.33	$181.97	$295.12
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $50.12 / $72.44	Professional	26	$33.11	$50.12	$72.44
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 / $64.57 / $162.18	Professional		$32.36	$64.57	$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 $38.02 / $45.71 / $87.10	Professional	26	$38.02	$45.71	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $128.82 / $239.88	Professional	TC	$81.28	$128.82	$239.88
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 $64.57 / $64.57 / $79.43	Professional	TC	$64.57	$64.57	$79.43