Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $42.66 / $181.97	Facility	26	$34.67	$42.66	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $199.53 / $501.19	Professional		$144.54	$199.53	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $48.98 / $125.89	Professional	26	$35.48	$48.98	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $144.54 / $281.84	Professional	TC	$109.65	$144.54	$281.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $162.18	Professional		$134.90	$154.88	$162.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $53.70 / $89.13	Professional	26	$38.90	$53.70	$89.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $58.88 / $85.11	Facility	26	$12.59	$58.88	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $288.40 / $537.03	Professional		$151.36	$288.40	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $58.88 / $117.49	Professional	26	$37.15	$58.88	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $194.98 / $389.05	Professional	TC	$109.65	$194.98	$389.05
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 $134.90 / $218.78 / $331.13	Professional		$134.90	$218.78	$331.13
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $53.70 / $79.43	Professional	26	$35.48	$53.70	$79.43
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $165.96 / $251.19	Professional	TC	$97.72	$165.96	$251.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $186.21	Professional		$32.36	$33.11	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $199.53 / $398.11	Professional		$169.82	$199.53	$398.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $48.98 / $97.72	Professional	26	$41.69	$48.98	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $151.36 / $295.12	Professional	TC	$128.82	$151.36	$295.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $190.55	Professional		$165.96	$165.96	$190.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $42.66 / $50.12	Professional	26	$42.66	$42.66	$50.12
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $125.89 / $141.25	Professional	TC	$125.89	$125.89	$141.25