Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.04 / $21.99 / $85.13	Facility	26	$18.04	$21.99	$85.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.90 / $92.45 / $194.69	Professional		$69.90	$92.45	$194.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.04 / $24.64 / $62.65	Professional	26	$18.04	$24.64	$62.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.86 / $66.56 / $103.12	Professional	TC	$51.86	$66.56	$103.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.08 / $79.23 / $222.86	Professional		$62.08	$79.23	$222.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $20.67 / $45.13	Professional	26	$19.05	$20.67	$45.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $59.25 / $59.25 / $59.25	Professional	TC	$59.25	$59.25	$59.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.72 / $29.72 / $80.95	Facility	26	$29.72	$29.72	$80.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.95 / $102.77 / $213.48	Professional		$72.95	$102.77	$213.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.66 / $29.80 / $57.99	Professional	26	$18.66	$29.80	$57.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.03 / $76.69 / $159.84	Professional	TC	$54.03	$76.69	$159.84
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $29.32 / $29.32 / $29.32	Facility	26	$29.32	$29.32	$29.32
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $69.33 / $96.35 / $134.66	Professional		$69.33	$96.35	$134.66
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $17.48 / $28.38 / $39.26	Professional	26	$17.48	$28.38	$39.26
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $51.44 / $67.51 / $96.31	Professional	TC	$51.44	$67.51	$96.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $85.40 / $175.70	Professional		$36.17	$85.40	$175.70
United Facility/Professional Professional Modifier Low / Median / High Price $76.45 / $94.09 / $175.39	Professional		$76.45	$94.09	$175.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.40 / $24.40 / $43.26	Professional	26	$21.40	$24.40	$43.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.60 / $70.81 / $129.44	Professional	TC	$55.60	$70.81	$129.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $59.82 / $59.82 / $59.82	Professional		$59.82	$59.82	$59.82
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.39 / $14.39 / $14.39	Professional	26	$14.39	$14.39	$14.39
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $45.42 / $45.42 / $45.42	Professional	TC	$45.42	$45.42	$45.42