Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.50 / $23.24 / $107.66	Facility	26	$22.50	$23.24	$107.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.23 / $99.89 / $167.83	Professional		$72.23	$99.89	$167.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.50 / $31.21 / $49.90	Professional	26	$22.50	$31.21	$49.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.73 / $68.67 / $99.58	Professional	TC	$49.73	$68.67	$99.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.58 / $226.64 / $226.64	Professional		$80.58	$226.64	$226.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.87 / $43.29 / $67.73	Professional	26	$24.87	$43.29	$67.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.52 / $117.53 / $208.75	Professional		$76.52	$117.53	$208.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.56 / $39.01 / $68.15	Professional	26	$23.56	$39.01	$68.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.97 / $79.97 / $148.24	Professional	TC	$52.97	$79.97	$148.24
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $36.43 / $36.43 / $36.43	Facility	26	$36.43	$36.43	$36.43
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $75.54 / $116.08 / $151.38	Professional		$75.54	$116.08	$151.38
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $23.93 / $37.79 / $49.55	Professional	26	$23.93	$37.79	$49.55
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $51.44 / $78.28 / $102.78	Professional	TC	$51.44	$78.28	$102.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $81.30 / $139.73	Professional		$36.17	$81.30	$139.73
United Facility/Professional Professional Modifier Low / Median / High Price $81.87 / $94.70 / $196.51	Professional		$81.87	$94.70	$196.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.74 / $31.08 / $62.74	Professional	26	$26.74	$31.08	$62.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.72 / $63.92 / $124.66	Professional	TC	$54.72	$63.92	$124.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $75.00	Professional		$75.00	$75.00	$75.00
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.34 / $22.34 / $22.34	Professional	26	$22.34	$22.34	$22.34
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $52.66 / $52.66 / $52.66	Professional	TC	$52.66	$52.66	$52.66