Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $33.88 / $169.82	Facility	26	$30.90	$33.88	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $95.50 / $275.42	Professional		$67.61	$95.50	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $39.81 / $120.23	Professional	26	$16.60	$39.81	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $53.70 / $213.80	Professional	TC	$35.48	$53.70	$213.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $72.44 / $95.50	Professional		$64.57	$72.44	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $37.15 / $72.44	Professional	26	$33.88	$37.15	$72.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $52.48 / $74.13	Facility	26	$11.22	$52.48	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $109.65 / $457.09	Professional		$67.61	$109.65	$457.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $32.36 / $85.11	Professional	26	$14.13	$32.36	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $79.43 / $457.09	Professional	TC	$35.48	$79.43	$457.09
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $19.05 / $19.05	Facility	26	$19.05	$19.05	$19.05
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $100.00 / $426.58	Professional		$66.07	$100.00	$426.58
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $22.39 / $42.66	Professional	26	$14.13	$22.39	$42.66
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $67.61 / $436.52	Professional	TC	$36.31	$67.61	$436.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $34.67 / $91.20	Professional		$28.18	$34.67	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $112.20 / $363.08	Professional		$74.13	$112.20	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $36.31 / $64.57	Professional	26	$14.45	$36.31	$64.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $69.18 / $309.03	Professional	TC	$45.71	$69.18	$309.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $93.33	Professional		$57.54	$57.54	$93.33
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $26.92 / $44.67	Professional	26	$26.92	$26.92	$44.67
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $30.20 / $48.98	Professional	TC	$30.20	$30.20	$48.98