Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $23.60 / $99.10	Facility	26	$19.60	$23.60	$99.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.43 / $89.64 / $171.03	Professional		$64.43	$89.64	$171.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.60 / $25.08 / $61.97	Professional	26	$19.60	$25.08	$61.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.84 / $61.80 / $94.77	Professional	TC	$44.84	$61.80	$94.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.35 / $71.53 / $201.17	Professional		$54.35	$71.53	$201.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.80 / $37.15 / $52.23	Professional	26	$19.80	$37.15	$52.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $67.51	Facility	26	$32.40	$32.40	$67.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.45 / $91.25 / $179.59	Professional		$64.45	$91.25	$179.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.71 / $27.60 / $57.02	Professional	26	$18.71	$27.60	$57.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.62 / $66.19 / $125.70	Professional	TC	$47.62	$66.19	$125.70
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $24.63 / $24.63 / $24.63	Facility	26	$24.63	$24.63	$24.63
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $62.59 / $89.65 / $121.32	Professional		$62.59	$89.65	$121.32
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $19.18 / $25.91 / $35.72	Professional	26	$19.18	$25.91	$35.72
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $43.33 / $63.11 / $88.36	Professional	TC	$43.33	$63.11	$88.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $78.52 / $137.79	Professional		$35.58	$78.52	$137.79
United Facility/Professional Professional Modifier Low / Median / High Price $64.09 / $79.56 / $164.68	Professional		$64.09	$79.56	$164.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.97 / $24.79 / $50.09	Professional	26	$17.97	$24.79	$50.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.12 / $54.65 / $112.04	Professional	TC	$46.12	$54.65	$112.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $52.43 / $52.43 / $52.43	Professional		$52.43	$52.43	$52.43
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $15.08 / $15.08 / $15.08	Professional	26	$15.08	$15.08	$15.08
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $37.34 / $37.34 / $37.34	Professional	TC	$37.34	$37.34	$37.34