Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.37 / $21.42 / $87.08	Facility	26	$17.37	$21.42	$87.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.81 / $103.49 / $202.18	Professional		$82.81	$103.49	$202.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.37 / $24.28 / $66.15	Professional	26	$17.37	$24.28	$66.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.92 / $78.47 / $140.32	Professional	TC	$59.92	$78.47	$140.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.54 / $23.72 / $42.15	Professional	26	$18.54	$23.72	$42.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.92 / $28.92 / $77.53	Facility	26	$28.92	$28.92	$77.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.87 / $106.97 / $223.76	Professional		$68.87	$106.97	$223.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.19 / $29.31 / $53.39	Professional	26	$18.19	$29.31	$53.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.24 / $83.88 / $181.77	Professional	TC	$54.24	$83.88	$181.77
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $28.24 / $28.24 / $28.24	Facility	26	$28.24	$28.24	$28.24
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $122.70 / $172.81	Professional		$72.44	$122.70	$172.81
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $17.50 / $29.79 / $37.07	Professional	26	$17.50	$29.79	$37.07
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $49.08 / $102.07 / $137.40	Professional	TC	$49.08	$102.07	$137.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.75 / $110.28 / $190.97	Professional		$35.75	$110.28	$190.97
United Facility/Professional Professional Modifier Low / Median / High Price $67.76 / $101.64 / $209.94	Professional		$67.76	$101.64	$209.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.98 / $22.81 / $47.95	Professional	26	$19.98	$22.81	$47.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.14 / $79.84 / $168.62	Professional	TC	$47.14	$79.84	$168.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.04 / $62.04 / $62.04	Professional		$62.04	$62.04	$62.04
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.44 / $12.44 / $12.44	Professional	26	$12.44	$12.44	$12.44
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $49.60 / $49.60 / $49.60	Professional	TC	$49.60	$49.60	$49.60