Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.16 / $26.18 / $100.14	Facility	26	$21.16	$26.18	$100.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.07 / $82.59 / $204.30	Professional		$54.07	$82.59	$204.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.16 / $29.94 / $103.84	Professional	26	$21.16	$29.94	$103.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.90 / $49.56 / $94.12	Professional	TC	$32.90	$49.56	$94.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.34 / $81.56 / $129.13	Professional		$58.34	$81.56	$129.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.81 / $31.17 / $63.00	Professional	26	$22.81	$31.17	$63.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $44.29 / $47.45	Professional	TC	$38.90	$44.29	$47.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.11 / $35.11 / $95.03	Facility	26	$35.11	$35.11	$95.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.16 / $89.11 / $173.85	Professional		$56.16	$89.11	$173.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.15 / $34.27 / $67.80	Professional	26	$22.15	$34.27	$67.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.01 / $56.10 / $107.50	Professional	TC	$34.01	$56.10	$107.50
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $35.01 / $35.01 / $35.01	Facility	26	$35.01	$35.01	$35.01
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $52.87 / $88.23 / $117.47	Professional		$52.87	$88.23	$117.47
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $20.82 / $33.97 / $45.47	Professional	26	$20.82	$33.97	$45.47
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $32.04 / $54.25 / $71.52	Professional	TC	$32.04	$54.25	$71.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.13 / $51.09 / $132.66	Professional		$29.13	$51.09	$132.66
United Facility/Professional Professional Modifier Low / Median / High Price $64.81 / $74.55 / $136.41	Professional		$64.81	$74.55	$136.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.39 / $27.32 / $51.33	Professional	26	$24.39	$27.32	$51.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.72 / $47.00 / $82.50	Professional	TC	$39.72	$47.00	$82.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.94 / $50.94 / $50.94	Professional		$50.94	$50.94	$50.94
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $19.07 / $19.07 / $19.07	Professional	26	$19.07	$19.07	$19.07
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $31.86 / $31.86 / $31.86	Professional	TC	$31.86	$31.86	$31.86