Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $41.69 / $323.59	Facility	26	$19.95	$41.69	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $72.44 / $218.78	Professional		$50.12	$72.44	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $28.18 / $72.44	Professional	26	$20.89	$28.18	$72.44
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $144.54 / $204.17 / $741.31	Professional	50	$144.54	$204.17	$741.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $39.81 / $87.10	Professional	TC	$28.84	$39.81	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $58.88 / $74.13	Professional		$54.95	$58.88	$74.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $64.57 / $75.86	Professional	26	$64.57	$64.57	$75.86
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $151.36 / $151.36 / $177.83	Professional	50	$151.36	$151.36	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $36.31 / $61.66	Facility	26	$7.76	$36.31	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $89.13 / $186.21	Professional		$52.48	$89.13	$186.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $37.15 / $74.13	Professional	26	$22.39	$37.15	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $57.54 / $123.03	Professional	TC	$29.51	$57.54	$123.03
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $37.15 / $37.15	Facility	26	$37.15	$37.15	$37.15
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $87.10 / $125.89	Professional		$52.48	$87.10	$125.89
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $32.36 / $48.98	Professional	26	$22.39	$32.36	$48.98
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $53.70 / $81.28	Professional	TC	$29.51	$53.70	$81.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $35.48 / $69.18	Professional		$26.30	$35.48	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $151.36	Professional		$66.07	$81.28	$151.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $29.51 / $54.95	Professional	26	$25.70	$29.51	$54.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $52.48 / $93.33	Professional	TC	$39.81	$52.48	$93.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $74.13	Professional		$57.54	$57.54	$74.13
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $24.55 / $31.62	Professional	26	$24.55	$24.55	$31.62
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $32.36 / $42.66	Professional	TC	$32.36	$32.36	$42.66