Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $18.20 / $89.13	Facility	26	$18.20	$18.20	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $107.15 / $295.12	Professional		$69.18	$107.15	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $30.90 / $77.62	Professional	26	$18.20	$30.90	$77.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $72.44 / $169.82	Professional	TC	$51.29	$72.44	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $83.18 / $181.97	Professional		$67.61	$83.18	$181.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.30 / $47.86	Professional	26	$19.95	$26.30	$47.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $64.57 / $95.50	Professional	TC	$57.54	$64.57	$95.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.31 / $29.51 / $50.12	Facility	26	$6.31	$29.51	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $104.71 / $213.80	Professional		$72.44	$104.71	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $30.20 / $57.54	Professional	26	$18.62	$30.20	$57.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $77.62 / $169.82	Professional	TC	$51.29	$77.62	$169.82
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $29.51 / $29.51	Facility	26	$29.51	$29.51	$29.51
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $85.11 / $138.04	Professional		$70.79	$85.11	$138.04
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $25.70 / $39.81	Professional	26	$18.20	$25.70	$39.81
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $61.66 / $97.72	Professional	TC	$48.98	$61.66	$97.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $41.69 / $102.33	Professional		$18.20	$41.69	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $95.50 / $173.78	Professional		$75.86	$95.50	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $24.55 / $44.67	Professional	26	$20.89	$24.55	$44.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $70.79 / $131.83	Professional	TC	$54.95	$70.79	$131.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $102.33	Professional		$66.07	$66.07	$102.33
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $15.85 / $25.70	Professional	26	$15.85	$15.85	$25.70
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $50.12 / $77.62	Professional	TC	$50.12	$50.12	$77.62