Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.05 / $51.30 / $175.09	Facility	26	$50.05	$51.30	$175.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.80 / $171.00 / $323.81	Professional		$134.80	$171.00	$323.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.74 / $52.88 / $133.65	Professional	26	$46.74	$52.88	$133.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.14 / $119.70 / $220.00	Professional	TC	$83.14	$119.70	$220.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.50 / $94.71 / $131.33	Professional		$80.50	$94.71	$131.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.63 / $48.94 / $93.81	Professional	26	$35.63	$48.94	$93.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $61.62 / $61.62 / $88.12	Professional	TC	$61.62	$61.62	$88.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.04 / $59.04 / $158.09	Facility	26	$59.04	$59.04	$158.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.34 / $191.06 / $403.00	Professional		$98.34	$191.06	$403.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.61 / $57.76 / $109.42	Professional	26	$36.61	$57.76	$109.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.57 / $133.00 / $290.97	Professional	TC	$61.57	$133.00	$290.97
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $57.92 / $57.92 / $57.92	Facility	26	$57.92	$57.92	$57.92
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $106.65 / $173.31 / $287.06	Professional		$106.65	$173.31	$287.06
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $40.54 / $60.09 / $76.02	Professional	26	$40.54	$60.09	$76.02
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $68.45 / $109.78 / $219.66	Professional	TC	$68.45	$109.78	$219.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.74 / $110.46 / $191.55	Professional		$37.74	$110.46	$191.55
United Facility/Professional Professional Modifier Low / Median / High Price $112.58 / $168.92 / $336.81	Professional		$112.58	$168.92	$336.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.70 / $46.14 / $95.31	Professional	26	$39.70	$46.14	$95.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.77 / $104.66 / $231.42	Professional	TC	$69.77	$104.66	$231.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.33 / $87.33 / $87.33	Professional		$87.33	$87.33	$87.33
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $32.67 / $32.67 / $32.67	Professional	26	$32.67	$32.67	$32.67
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $54.66 / $54.66 / $54.66	Professional	TC	$54.66	$54.66	$54.66