Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.09 / $41.18 / $171.29	Facility	26	$33.09	$41.18	$171.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.36 / $133.99 / $234.09	Professional		$101.36	$133.99	$234.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $41.92 / $104.51	Professional	26	$29.91	$41.92	$104.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.26 / $91.91 / $143.34	Professional	TC	$68.26	$91.91	$143.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.04 / $97.04 / $315.68	Professional		$97.04	$97.04	$315.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.69 / $63.17 / $100.76	Professional	26	$33.69	$63.17	$100.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.98 / $55.98 / $100.04	Facility	26	$55.98	$55.98	$100.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.82 / $144.15 / $279.14	Professional		$105.82	$144.15	$279.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.42 / $41.48 / $88.49	Professional	26	$28.42	$41.48	$88.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.70 / $110.10 / $212.27	Professional	TC	$71.70	$110.10	$212.27
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $36.81 / $36.81 / $36.81	Facility	26	$36.81	$36.81	$36.81
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $98.21 / $151.47 / $204.49	Professional		$98.21	$151.47	$204.49
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $29.10 / $38.86 / $55.21	Professional	26	$29.10	$38.86	$55.21
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $64.80 / $111.56 / $156.18	Professional	TC	$64.80	$111.56	$156.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.60 / $111.39 / $191.87	Professional		$36.60	$111.39	$191.87
United Facility/Professional Professional Modifier Low / Median / High Price $103.74 / $127.30 / $272.11	Professional		$103.74	$127.30	$272.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.80 / $42.43 / $79.58	Professional	26	$26.80	$42.43	$79.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.94 / $95.23 / $180.98	Professional	TC	$76.94	$95.23	$180.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.03 / $89.03 / $89.03	Professional		$89.03	$89.03	$89.03
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $28.07 / $28.07 / $28.07	Professional	26	$28.07	$28.07	$28.07
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $60.97 / $60.97 / $60.97	Professional	TC	$60.97	$60.97	$60.97