Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.68 / $154.75	Facility	26	$51.29	$51.68	$154.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.22 / $171.00 / $300.00	Professional		$131.22	$171.00	$300.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $51.30 / $120.15	Professional	26	$44.14	$51.30	$120.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.77 / $119.70 / $220.00	Professional	TC	$84.77	$119.70	$220.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.65 / $98.32 / $276.52	Professional		$78.65	$98.32	$276.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.79 / $58.75 / $97.36	Professional	26	$34.79	$58.75	$97.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $146.02	Facility	26	$54.02	$54.02	$146.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.25 / $214.09 / $416.74	Professional		$96.25	$214.09	$416.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.13 / $55.60 / $110.36	Professional	26	$33.13	$55.60	$110.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.28 / $158.21 / $323.23	Professional	TC	$62.28	$158.21	$323.23
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $53.23 / $53.23 / $53.23	Facility	26	$53.23	$53.23	$53.23
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $122.90 / $210.63 / $303.89	Professional		$122.90	$210.63	$303.89
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $37.26 / $56.56 / $71.08	Professional	26	$37.26	$56.56	$71.08
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $85.19 / $153.26 / $232.13	Professional	TC	$85.19	$153.26	$232.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $111.13 / $191.55	Professional		$37.20	$111.13	$191.55
United Facility/Professional Professional Modifier Low / Median / High Price $121.97 / $177.90 / $356.49	Professional		$121.97	$177.90	$356.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.34 / $45.91 / $93.77	Professional	26	$37.34	$45.91	$93.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.98 / $128.19 / $276.75	Professional	TC	$80.98	$128.19	$276.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $99.87 / $99.87 / $99.87	Professional		$99.87	$99.87	$99.87
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $35.04 / $35.04 / $35.04	Professional	26	$35.04	$35.04	$35.04
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $64.83 / $64.83 / $64.83	Professional	TC	$64.83	$64.83	$64.83