Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $48.98 / $162.18	Facility	26	$31.62	$48.98	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $204.17 / $489.78	Professional		$102.33	$204.17	$489.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $74.13 / $190.55	Professional	26	$36.31	$74.13	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $95.50 / $204.17	Professional	TC	$58.88	$95.50	$204.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $112.20 / $190.55	Professional		$87.10	$112.20	$190.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $46.77 / $75.86	Professional	26	$35.48	$46.77	$75.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $67.61 / $109.65	Professional	TC	$50.12	$67.61	$109.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $53.70 / $93.33	Facility	26	$11.48	$53.70	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $144.54 / $288.40	Professional		$93.33	$144.54	$288.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $52.48 / $104.71	Professional	26	$33.11	$52.48	$104.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $95.50 / $190.55	Professional	TC	$60.26	$95.50	$190.55
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $53.70 / $53.70	Facility	26	$53.70	$53.70	$53.70
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $131.83 / $199.53	Professional		$93.33	$131.83	$199.53
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $46.77 / $70.79	Professional	26	$33.11	$46.77	$70.79
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $81.28 / $128.82	Professional	TC	$60.26	$81.28	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $61.66 / $125.89	Professional		$32.36	$61.66	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $123.03 / $218.78	Professional		$104.71	$123.03	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $42.66 / $77.62	Professional	26	$37.15	$42.66	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $79.43 / $141.25	Professional	TC	$67.61	$79.43	$141.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $131.83	Professional		$93.33	$93.33	$131.83
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $33.11 / $46.77	Professional	26	$33.11	$33.11	$46.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $61.66 / $85.11	Professional	TC	$61.66	$61.66	$85.11