Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.38 / $24.55 / $97.72	Facility	26	$21.38	$24.55	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $123.03 / $309.03	Professional		$61.66	$123.03	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $52.48 / $125.89	Professional	26	$25.12	$52.48	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $56.23 / $117.49	Professional	TC	$33.11	$56.23	$117.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $67.61 / $120.23	Professional		$52.48	$67.61	$120.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $31.62 / $53.70	Professional	26	$23.44	$31.62	$53.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $41.69 / $74.13	Professional	TC	$33.88	$41.69	$74.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $35.48 / $60.26	Facility	26	$7.59	$35.48	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $89.13 / $173.78	Professional		$56.23	$89.13	$173.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $34.67 / $67.61	Professional	26	$22.39	$34.67	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $58.88 / $112.20	Professional	TC	$34.67	$58.88	$112.20
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $34.67 / $34.67	Facility	26	$34.67	$34.67	$34.67
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $77.62 / $117.49	Professional		$56.23	$77.62	$117.49
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $30.90 / $45.71	Professional	26	$21.88	$30.90	$45.71
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $47.86 / $72.44	Professional	TC	$33.88	$47.86	$72.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $36.31 / $74.13	Professional		$23.99	$36.31	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $75.86 / $134.90	Professional		$64.57	$75.86	$134.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $27.54 / $51.29	Professional	26	$23.99	$27.54	$51.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $47.86 / $83.18	Professional	TC	$39.81	$47.86	$83.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $79.43	Professional		$56.23	$56.23	$79.43
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $21.38 / $30.90	Professional	26	$21.38	$21.38	$30.90
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $34.67 / $48.98	Professional	TC	$34.67	$34.67	$48.98