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 / $158.49	Facility	26	$51.29	$51.29	$158.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $190.55 / $549.54	Professional		$134.90	$190.55	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $61.66 / $169.82	Professional	26	$47.86	$61.66	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $120.23 / $245.47	Professional	TC	$83.18	$120.23	$245.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $107.15 / $223.87	Professional		$89.13	$107.15	$223.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $52.48 / $85.11	Professional	26	$38.02	$52.48	$85.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $60.26 / $79.43	Professional	TC	$60.26	$60.26	$79.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $58.88 / $100.00	Facility	26	$12.59	$58.88	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $190.55 / $407.38	Professional		$97.72	$190.55	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $57.54 / $112.20	Professional	26	$36.31	$57.54	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $131.83 / $288.40	Professional	TC	$61.66	$131.83	$288.40
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $57.54 / $57.54	Facility	26	$57.54	$57.54	$57.54
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $162.18 / $263.03	Professional		$95.50	$162.18	$263.03
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $52.48 / $75.86	Professional	26	$35.48	$52.48	$75.86
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $100.00 / $204.17	Professional	TC	$58.88	$100.00	$204.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $64.57 / $154.88	Professional		$32.36	$64.57	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $169.82 / $309.03	Professional		$112.20	$169.82	$309.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $46.77 / $91.20	Professional	26	$40.74	$46.77	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $104.71 / $223.87	Professional	TC	$69.18	$104.71	$223.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $128.82	Professional		$95.50	$95.50	$128.82
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $36.31 / $50.12	Professional	26	$36.31	$36.31	$50.12
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $60.26 / $79.43	Professional	TC	$60.26	$60.26	$79.43