Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.53 / $51.30 / $154.75	Facility	26	$49.53	$51.30	$154.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.04 / $171.59 / $353.78	Professional		$131.04	$171.59	$353.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $51.30 / $128.25	Professional	26	$44.14	$51.30	$128.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.12 / $119.70 / $225.03	Professional	TC	$84.12	$119.70	$225.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.45 / $101.28 / $200.94	Professional		$78.45	$101.28	$200.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.57 / $56.29 / $97.36	Professional	26	$34.57	$56.29	$97.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.80 / $58.80 / $83.90	Professional	TC	$58.80	$58.80	$83.90
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 $95.78 / $201.61 / $410.49	Professional		$95.78	$201.61	$410.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.13 / $57.00 / $101.06	Professional	26	$33.13	$57.00	$101.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.34 / $152.79 / $312.19	Professional	TC	$65.34	$152.79	$312.19
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 $122.59 / $210.63 / $303.89	Professional		$122.59	$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 $84.85 / $152.43 / $231.69	Professional	TC	$84.85	$152.43	$231.69
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 $121.42 / $177.38 / $360.06	Professional		$121.42	$177.38	$360.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.03 / $45.40 / $89.36	Professional	26	$38.03	$45.40	$89.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.43 / $123.66 / $263.10	Professional	TC	$80.43	$123.66	$263.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $99.83 / $99.83 / $99.83	Professional		$99.83	$99.83	$99.83
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 $64.62 / $64.62 / $64.62	Professional	TC	$64.62	$64.62	$64.62