Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.64 / $39.75 / $153.66	Facility	26	$31.64	$39.75	$153.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.75 / $117.46 / $286.23	Professional		$77.75	$117.46	$286.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.64 / $45.13 / $113.13	Professional	26	$31.64	$45.13	$113.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.11 / $67.70 / $126.96	Professional	TC	$46.11	$67.70	$126.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.22 / $99.84 / $153.87	Professional		$76.22	$99.84	$153.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.85 / $48.41 / $85.58	Professional	26	$34.85	$48.41	$85.58
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $54.16 / $61.67 / $98.19	Professional	TC	$54.16	$61.67	$98.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.62 / $53.62 / $145.01	Facility	26	$53.62	$53.62	$145.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.95 / $129.30 / $255.95	Professional		$80.95	$129.30	$255.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $51.99 / $100.81	Professional	26	$33.11	$51.99	$100.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.84 / $76.20 / $151.00	Professional	TC	$47.84	$76.20	$151.00
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $53.24 / $53.24 / $53.24	Facility	26	$53.24	$53.24	$53.24
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $76.22 / $113.82 / $169.10	Professional		$76.22	$113.82	$169.10
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $51.95 / $69.20	Professional	26	$31.62	$51.95	$69.20
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $42.64 / $67.23 / $99.90	Professional	TC	$42.64	$67.23	$99.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.40 / $83.14 / $144.23	Professional		$37.40	$83.14	$144.23
United Facility/Professional Professional Modifier Low / Median / High Price $93.67 / $105.14 / $195.63	Professional		$93.67	$105.14	$195.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.46 / $41.97 / $77.97	Professional	26	$37.46	$41.97	$77.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.85 / $65.69 / $120.71	Professional	TC	$55.85	$65.69	$120.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $74.08 / $74.08 / $74.08	Professional		$74.08	$74.08	$74.08
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $29.26 / $29.26 / $29.26	Professional	26	$29.26	$29.26	$29.26
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $44.83 / $44.83 / $44.83	Professional	TC	$44.83	$44.83	$44.83