Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $75.86 / $338.84	Facility	26	$63.10	$75.86	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $165.96 / $354.81	Professional		$114.82	$165.96	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $83.18 / $295.12	Professional	26	$52.48	$83.18	$295.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $75.86 / $162.18	Professional	26	$70.79	$75.86	$162.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $107.15 / $165.96	Facility	26	$22.91	$107.15	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $181.97 / $562.34	Professional		$120.23	$181.97	$562.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $70.79 / $165.96	Professional	26	$44.67	$70.79	$165.96
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $58.88 / $58.88	Facility	26	$58.88	$58.88	$58.88
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $169.82 / $457.09	Professional		$117.49	$169.82	$457.09
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $64.57 / $107.15	Professional	26	$44.67	$64.57	$107.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $61.66 / $154.88	Professional		$32.36	$61.66	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $190.55 / $436.52	Professional		$128.82	$190.55	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $79.43 / $138.04	Professional	26	$44.67	$79.43	$138.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $165.96	Professional		$97.72	$97.72	$165.96
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $53.70 / $91.20	Professional	26	$53.70	$53.70	$91.20