Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $45.71 / $144.54	Facility	26	$26.92	$45.71	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $165.96 / $426.58	Professional		$75.86	$165.96	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $66.07 / $169.82	Professional	26	$30.20	$66.07	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $70.79 / $173.78	Professional	TC	$45.71	$70.79	$173.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $95.50 / $165.96	Professional		$74.13	$95.50	$165.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $39.81 / $63.10	Professional	26	$30.90	$39.81	$63.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $64.57 / $95.50	Professional	TC	$47.86	$64.57	$95.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $45.71 / $79.43	Facility	26	$9.77	$45.71	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $107.15 / $223.87	Professional		$74.13	$107.15	$223.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $44.67 / $91.20	Professional	26	$28.18	$44.67	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $67.61 / $147.91	Professional	TC	$46.77	$67.61	$147.91
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $47.86 / $47.86	Facility	26	$47.86	$47.86	$47.86
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $91.20 / $154.88	Professional		$60.26	$91.20	$154.88
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $35.48 / $60.26	Professional	26	$24.55	$35.48	$60.26
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $56.23 / $95.50	Professional	TC	$35.48	$56.23	$95.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $51.29 / $100.00	Professional		$30.90	$51.29	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $95.50 / $173.78	Professional		$81.28	$95.50	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $36.31 / $67.61	Professional	26	$31.62	$36.31	$67.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $58.88 / $109.65	Professional	TC	$48.98	$58.88	$109.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $107.15	Professional		$75.86	$75.86	$107.15
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $28.18 / $40.74	Professional	26	$28.18	$28.18	$40.74
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $47.86 / $67.61	Professional	TC	$47.86	$47.86	$67.61