Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.77 / $26.26 / $96.45	Facility	26	$18.77	$26.26	$96.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.57 / $113.98 / $177.95	Professional		$92.57	$113.98	$177.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.77 / $25.04 / $36.09	Professional	26	$18.77	$25.04	$36.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $226.24 / $226.24 / $226.24	Professional		$226.24	$226.24	$226.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.97 / $23.97 / $23.97	Professional	26	$23.97	$23.97	$23.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.86 / $34.86 / $84.32	Facility	26	$34.86	$34.86	$84.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.50 / $129.15 / $250.28	Professional		$86.50	$129.15	$250.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.90 / $31.47 / $57.56	Professional	26	$20.90	$31.47	$57.56
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $164.71 / $164.71 / $164.71	Professional	50	$164.71	$164.71	$164.71
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $29.96 / $29.96 / $29.96	Facility	26	$29.96	$29.96	$29.96
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $75.41 / $127.42 / $155.57	Professional		$75.41	$127.42	$155.57
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $21.64 / $30.70 / $40.72	Professional	26	$21.64	$30.70	$40.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.89 / $83.35 / $172.51	Professional		$35.89	$83.35	$172.51
United Facility/Professional Professional Modifier Low / Median / High Price $90.22 / $112.86 / $221.73	Professional		$90.22	$112.86	$221.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.13 / $25.04 / $53.62	Professional	26	$21.13	$25.04	$53.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.56 / $67.56 / $67.56	Professional		$67.56	$67.56	$67.56
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $18.52 / $18.52 / $18.52	Professional	26	$18.52	$18.52	$18.52