Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $62.25 / $201.62	Facility	26	$51.29	$62.25	$201.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $220.45 / $347.89	Professional		$171.00	$220.45	$347.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $56.67 / $112.50	Professional	26	$51.30	$56.67	$112.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.29 / $142.62 / $261.00	Professional	TC	$114.29	$142.62	$261.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $137.05 / $362.77 / $362.77	Professional		$137.05	$362.77	$362.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.23 / $75.18 / $118.60	Professional	26	$43.23	$75.18	$118.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.34 / $66.34 / $177.59	Facility	26	$66.34	$66.34	$177.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.59 / $271.56 / $507.57	Professional		$123.59	$271.56	$507.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.16 / $65.37 / $124.63	Professional	26	$41.16	$65.37	$124.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.51 / $199.38 / $404.09	Professional	TC	$84.51	$199.38	$404.09
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $65.05 / $65.05 / $65.05	Facility	26	$65.05	$65.05	$65.05
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $161.22 / $257.89 / $361.06	Professional		$161.22	$257.89	$361.06
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $45.53 / $67.48 / $85.38	Professional	26	$45.53	$67.48	$85.38
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $105.54 / $194.64 / $285.86	Professional	TC	$105.54	$194.64	$285.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $124.59 / $223.01	Professional		$41.40	$124.59	$223.01
United Facility/Professional Professional Modifier Low / Median / High Price $154.12 / $224.23 / $433.81	Professional		$154.12	$224.23	$433.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.39 / $52.91 / $109.86	Professional	26	$45.39	$52.91	$109.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.18 / $161.40 / $322.18	Professional	TC	$104.18	$161.40	$322.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $131.51 / $131.51 / $131.51	Professional		$131.51	$131.51	$131.51
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $43.25 / $43.25 / $43.25	Professional	26	$43.25	$43.25	$43.25
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $88.26 / $88.26 / $88.26	Professional	TC	$88.26	$88.26	$88.26