Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.01 / $51.30 / $132.19	Facility	26	$40.01	$51.30	$132.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.65 / $110.78 / $321.47	Professional		$71.65	$110.78	$321.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.50 / $49.90 / $83.00	Professional	26	$33.50	$49.90	$83.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.94 / $60.85 / $179.55	Professional	TC	$32.94	$60.85	$179.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.95 / $56.86 / $122.80	Professional		$47.95	$56.86	$122.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.86 / $48.94 / $67.52	Professional	26	$27.86	$48.94	$67.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.19 / $43.19 / $115.50	Facility	26	$43.19	$43.19	$115.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.35 / $89.85 / $214.31	Professional		$52.35	$89.85	$214.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.58 / $44.26 / $79.31	Professional	26	$26.58	$44.26	$79.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.76 / $41.85 / $144.72	Professional	TC	$25.76	$41.85	$144.72
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $42.50 / $42.50 / $42.50	Facility	26	$42.50	$42.50	$42.50
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $54.38 / $91.41 / $179.71	Professional		$54.38	$91.41	$179.71
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $26.90 / $44.09 / $55.78	Professional	26	$26.90	$44.09	$55.78
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $26.42 / $40.64 / $136.35	Professional	TC	$26.42	$40.64	$136.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.57 / $48.65 / $126.45	Professional		$26.57	$48.65	$126.45
United Facility/Professional Professional Modifier Low / Median / High Price $56.97 / $78.51 / $173.10	Professional		$56.97	$78.51	$173.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.65 / $34.63 / $71.56	Professional	26	$29.65	$34.63	$71.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.29 / $37.06 / $94.23	Professional	TC	$24.29	$37.06	$94.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $42.53 / $42.53 / $42.53	Professional		$42.53	$42.53	$42.53
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $20.35 / $20.35 / $20.35	Professional	26	$20.35	$20.35	$20.35
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.17 / $22.17 / $22.17	Professional	TC	$22.17	$22.17	$22.17