Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $42.66 / $169.82	Facility	26	$33.11	$42.66	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $323.59	Professional		$102.33	$138.04	$323.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $50.12 / $125.89	Professional	26	$33.11	$50.12	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $93.33 / $199.53	Professional	TC	$67.61	$93.33	$199.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $323.59	Professional		$316.23	$316.23	$323.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $52.48 / $87.10	Professional	26	$37.15	$52.48	$87.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $54.95 / $95.50	Facility	26	$12.02	$54.95	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $288.40	Professional		$102.33	$138.04	$288.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $40.74 / $91.20	Professional	26	$27.54	$40.74	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $107.15 / $229.09	Professional	TC	$72.44	$107.15	$229.09
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 $95.50 / $131.83 / $208.93	Professional		$95.50	$131.83	$208.93
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $36.31 / $57.54	Professional	26	$27.54	$36.31	$57.54
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $91.20 / $151.36	Professional	TC	$61.66	$91.20	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $66.07 / $165.96	Professional		$32.36	$66.07	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $125.89 / $245.47	Professional		$104.71	$125.89	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $42.66 / $74.13	Professional	26	$26.92	$42.66	$74.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $97.72 / $173.78	Professional	TC	$75.86	$97.72	$173.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $144.54	Professional		$97.72	$97.72	$144.54
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $31.62 / $47.86	Professional	26	$31.62	$31.62	$47.86
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $66.07 / $97.72	Professional	TC	$66.07	$66.07	$97.72