Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $57.67 / $187.74	Facility	26	$51.29	$57.67	$187.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.55 / $210.94 / $348.41	Professional		$165.55	$210.94	$348.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.03 / $55.67 / $139.05	Professional	26	$49.03	$55.67	$139.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $113.97 / $143.05 / $264.25	Professional	TC	$113.97	$143.05	$264.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $110.32 / $126.08 / $126.08	Professional		$110.32	$126.08	$126.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.67 / $61.60 / $112.21	Professional	26	$40.67	$61.60	$112.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.89 / $62.89 / $169.53	Facility	26	$62.89	$62.89	$169.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.33 / $247.31 / $489.71	Professional		$124.33	$247.31	$489.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.95 / $62.02 / $116.66	Professional	26	$38.95	$62.02	$116.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.03 / $180.68 / $361.18	Professional	TC	$85.03	$180.68	$361.18
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $61.80 / $61.80 / $61.80	Facility	26	$61.80	$61.80	$61.80
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $157.60 / $249.70 / $333.27	Professional		$157.60	$249.70	$333.27
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $43.26 / $63.20 / $81.11	Professional	26	$43.26	$63.20	$81.11
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $115.23 / $190.54 / $259.20	Professional	TC	$115.23	$190.54	$259.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $124.58 / $223.01	Professional		$41.40	$124.58	$223.01
United Facility/Professional Professional Modifier Low / Median / High Price $151.44 / $216.46 / $400.44	Professional		$151.44	$216.46	$400.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.15 / $49.56 / $101.86	Professional	26	$43.15	$49.56	$101.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.19 / $161.13 / $324.30	Professional	TC	$104.19	$161.13	$324.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $129.00 / $129.00 / $129.00	Professional		$129.00	$129.00	$129.00
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $40.99 / $40.99 / $40.99	Professional	26	$40.99	$40.99	$40.99
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $88.01 / $88.01 / $88.01	Professional	TC	$88.01	$88.01	$88.01