Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.59 / $36.33 / $163.24	Facility	26	$31.59	$36.33	$163.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.27 / $98.98 / $188.91	Professional		$67.27	$98.98	$188.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.71 / $31.59 / $62.50	Professional	26	$15.71	$31.59	$62.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.68 / $52.56 / $167.12	Professional	TC	$35.68	$52.56	$167.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.27 / $68.27 / $68.27	Professional		$68.27	$68.27	$68.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.22 / $59.75 / $99.85	Professional	26	$34.22	$59.75	$99.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.48 / $52.72 / $52.72	Facility	26	$50.48	$52.72	$52.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.41 / $114.75 / $515.40	Professional		$67.41	$114.75	$515.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.96 / $32.29 / $71.76	Professional	26	$14.96	$32.29	$71.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.46 / $82.10 / $491.10	Professional	TC	$34.46	$82.10	$491.10
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $18.84 / $18.84 / $18.84	Facility	26	$18.84	$18.84	$18.84
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $67.64 / $112.74 / $491.43	Professional		$67.64	$112.74	$491.43
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $14.76 / $22.37 / $36.97	Professional	26	$14.76	$22.37	$36.97
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $36.75 / $84.73 / $508.96	Professional	TC	$36.75	$84.73	$508.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.28 / $77.94 / $137.79	Professional		$34.28	$77.94	$137.79
United Facility/Professional Professional Modifier Low / Median / High Price $72.47 / $115.20 / $327.18	Professional		$72.47	$115.20	$327.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.30 / $35.38 / $65.14	Professional	26	$14.30	$35.38	$65.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.47 / $68.20 / $276.76	Professional	TC	$45.47	$68.20	$276.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.78 / $51.78 / $51.78	Professional		$51.78	$51.78	$51.78
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $24.37 / $24.37 / $24.37	Professional	26	$24.37	$24.37	$24.37
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $27.41 / $27.41 / $27.41	Professional	TC	$27.41	$27.41	$27.41