Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.11 / $61.92 / $159.85	Facility	26	$49.11	$61.92	$159.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.40 / $168.69 / $267.29	Professional		$115.40	$168.69	$267.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.90 / $51.30 / $79.90	Professional	26	$39.90	$51.30	$79.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.76 / $106.34 / $165.99	Professional	TC	$73.76	$106.34	$165.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.94 / $123.94 / $278.87	Professional		$123.94	$123.94	$278.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.79 / $66.69 / $75.50	Professional	26	$34.79	$66.69	$75.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.84 / $51.84 / $142.06	Facility	26	$51.84	$51.84	$142.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.22 / $190.00 / $329.35	Professional		$93.22	$190.00	$329.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.22 / $52.29 / $99.46	Professional	26	$32.22	$52.29	$99.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.64 / $124.79 / $241.79	Professional	TC	$64.64	$124.79	$241.79
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $52.14 / $52.14 / $52.14	Facility	26	$52.14	$52.14	$52.14
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $106.45 / $165.79 / $214.54	Professional		$106.45	$165.79	$214.54
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $36.50 / $53.03 / $68.44	Professional	26	$36.50	$53.03	$68.44
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $69.95 / $109.92 / $143.65	Professional	TC	$69.95	$109.92	$143.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $110.28 / $190.23	Professional		$36.17	$110.28	$190.23
United Facility/Professional Professional Modifier Low / Median / High Price $112.00 / $147.13 / $279.07	Professional		$112.00	$147.13	$279.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.71 / $41.53 / $90.57	Professional	26	$35.71	$41.53	$90.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.88 / $102.81 / $194.88	Professional	TC	$73.88	$102.81	$194.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $71.75 / $71.75 / $71.75	Professional		$71.75	$71.75	$71.75
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.92 / $23.92 / $23.92	Professional	26	$23.92	$23.92	$23.92
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $47.84 / $47.84 / $47.84	Professional	TC	$47.84	$47.84	$47.84