Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $33.88 / $147.91	Facility	26	$28.18	$33.88	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $338.84	Professional		$91.20	$131.83	$338.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $48.98 / $112.20	Professional	26	$28.84	$48.98	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $89.13 / $186.21	Professional	TC	$63.10	$89.13	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $295.12	Professional		$77.62	$107.15	$295.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $45.71 / $70.79	Professional	26	$30.20	$45.71	$70.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $47.86 / $83.18	Facility	26	$10.23	$47.86	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $263.03	Professional		$89.13	$123.03	$263.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $38.90 / $83.18	Professional	26	$26.92	$38.90	$83.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $91.20 / $204.17	Professional	TC	$63.10	$91.20	$204.17
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $37.15 / $37.15	Facility	26	$37.15	$37.15	$37.15
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $112.20 / $186.21	Professional		$91.20	$112.20	$186.21
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $33.11 / $53.70	Professional	26	$27.54	$33.11	$53.70
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $77.62 / $128.82	Professional	TC	$60.26	$77.62	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $53.70 / $144.54	Professional		$29.51	$53.70	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $114.82 / $208.93	Professional		$91.20	$114.82	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $37.15 / $67.61	Professional	26	$26.92	$37.15	$67.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $79.43 / $147.91	Professional	TC	$64.57	$79.43	$147.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $131.83	Professional		$83.18	$83.18	$131.83
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $25.70 / $41.69	Professional	26	$25.70	$25.70	$41.69
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $57.54 / $89.13	Professional	TC	$57.54	$57.54	$89.13