Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.64 / $40.02 / $153.66	Facility	26	$31.64	$40.02	$153.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.25 / $130.30 / $302.19	Professional		$89.25	$130.30	$302.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.64 / $44.81 / $109.26	Professional	26	$31.64	$44.81	$109.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.61 / $83.81 / $150.13	Professional	TC	$57.61	$83.81	$150.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.63 / $123.98 / $190.44	Professional		$87.63	$123.98	$190.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.07 / $50.03 / $75.65	Professional	26	$35.07	$50.03	$75.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $62.05 / $77.08 / $122.89	Professional	TC	$62.05	$77.08	$122.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.96 / $53.96 / $147.41	Facility	26	$53.96	$53.96	$147.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.11 / $142.91 / $281.04	Professional		$93.11	$142.91	$281.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.33 / $52.56 / $104.58	Professional	26	$33.33	$52.56	$104.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.78 / $93.27 / $186.71	Professional	TC	$59.78	$93.27	$186.71
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $53.87 / $53.87 / $53.87	Facility	26	$53.87	$53.87	$53.87
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $87.62 / $140.75 / $197.04	Professional		$87.62	$140.75	$197.04
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $31.83 / $53.04 / $70.03	Professional	26	$31.83	$53.04	$70.03
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $55.79 / $87.53 / $125.15	Professional	TC	$55.79	$87.53	$125.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.71 / $117.81 / $195.19	Professional		$37.71	$117.81	$195.19
United Facility/Professional Professional Modifier Low / Median / High Price $105.70 / $118.99 / $224.54	Professional		$105.70	$118.99	$224.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.46 / $41.97 / $77.22	Professional	26	$37.46	$41.97	$77.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.76 / $79.19 / $137.62	Professional	TC	$67.76	$79.19	$137.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.45 / $85.45 / $85.45	Professional		$85.45	$85.45	$85.45
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $29.39 / $29.39 / $29.39	Professional	26	$29.39	$29.39	$29.39
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $56.06 / $56.06 / $56.06	Professional	TC	$56.06	$56.06	$56.06