Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.09 / $40.35 / $171.84	Facility	26	$35.09	$40.35	$171.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.00 / $195.57 / $321.80	Professional		$145.00	$195.57	$321.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.09 / $46.97 / $70.14	Professional	26	$35.09	$46.97	$70.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.90 / $144.19 / $206.71	Professional	TC	$109.90	$144.19	$206.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.13 / $135.28 / $158.22	Professional		$60.13	$135.28	$158.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.09 / $82.15 / $83.60	Professional	26	$40.09	$82.15	$83.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.80 / $59.80 / $59.80	Facility	26	$59.80	$59.80	$59.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.58 / $287.93 / $525.00	Professional		$151.58	$287.93	$525.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.08 / $60.50 / $111.11	Professional	26	$37.08	$60.50	$111.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.88 / $202.79 / $373.14	Professional	TC	$108.88	$202.79	$373.14
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $58.85 / $58.85 / $58.85	Facility	26	$58.85	$58.85	$58.85
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $171.09 / $244.41 / $327.63	Professional		$171.09	$244.41	$327.63
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $41.19 / $59.84 / $79.22	Professional	26	$41.19	$59.84	$79.22
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $129.88 / $185.56 / $248.74	Professional	TC	$129.88	$185.56	$248.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.24 / $185.62 / $298.97	Professional		$41.24	$185.62	$298.97
United Facility/Professional Professional Modifier Low / Median / High Price $172.07 / $195.31 / $414.31	Professional		$172.07	$195.31	$414.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.92 / $48.23 / $100.14	Professional	26	$41.92	$48.23	$100.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $129.87 / $146.77 / $305.10	Professional	TC	$129.87	$146.77	$305.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $167.57 / $167.57 / $167.57	Professional		$167.57	$167.57	$167.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $42.79 / $42.79 / $42.79	Professional	26	$42.79	$42.79	$42.79
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $124.79 / $124.79 / $124.79	Professional	TC	$124.79	$124.79	$124.79