Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.29 / $30.53 / $121.91	Facility	26	$24.29	$30.53	$121.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.84 / $133.27 / $268.95	Professional		$98.84	$133.27	$268.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.29 / $32.57 / $92.25	Professional	26	$24.29	$32.57	$92.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.55 / $98.55 / $168.65	Professional	TC	$74.55	$98.55	$168.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.97 / $135.66 / $305.26	Professional		$94.97	$135.66	$305.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.61 / $52.04 / $77.69	Professional	26	$26.61	$52.04	$77.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $85.84 / $85.84 / $85.84	Professional	TC	$85.84	$85.84	$85.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.92 / $40.92 / $110.09	Facility	26	$40.92	$40.92	$110.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.26 / $144.41 / $299.51	Professional		$101.26	$144.41	$299.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.43 / $38.02 / $76.34	Professional	26	$25.43	$38.02	$76.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.83 / $105.40 / $226.16	Professional	TC	$75.83	$105.40	$226.16
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $40.06 / $40.06 / $40.06	Facility	26	$40.06	$40.06	$40.06
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $94.97 / $142.94 / $208.85	Professional		$94.97	$142.94	$208.85
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $24.28 / $36.83 / $52.08	Professional	26	$24.28	$36.83	$52.08
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $70.69 / $107.35 / $156.69	Professional	TC	$70.69	$107.35	$156.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $127.06 / $231.14	Professional		$37.20	$127.06	$231.14
United Facility/Professional Professional Modifier Low / Median / High Price $107.56 / $126.84 / $238.74	Professional		$107.56	$126.84	$238.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.28 / $32.11 / $57.62	Professional	26	$28.28	$32.11	$57.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.86 / $96.62 / $185.08	Professional	TC	$80.86	$96.62	$185.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.87 / $93.87 / $93.87	Professional		$93.87	$93.87	$93.87
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.51 / $22.51 / $22.51	Professional	26	$22.51	$22.51	$22.51
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $71.36 / $71.36 / $71.36	Professional	TC	$71.36	$71.36	$71.36