Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.28 / $30.10 / $115.18	Facility	26	$24.28	$30.10	$115.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $92.28 / $271.67	Professional		$61.66	$92.28	$271.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.28 / $34.36 / $92.48	Professional	26	$24.28	$34.36	$92.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.38 / $54.47 / $102.83	Professional	TC	$37.38	$54.47	$102.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.08 / $92.61 / $140.55	Professional		$64.08	$92.61	$140.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.46 / $36.79 / $61.92	Professional	26	$26.46	$36.79	$61.92
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $43.82 / $53.48 / $69.61	Professional	TC	$43.82	$53.48	$69.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.86 / $40.86 / $110.50	Facility	26	$40.86	$40.86	$110.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.88 / $101.14 / $197.57	Professional		$63.88	$101.14	$197.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.41 / $39.77 / $78.17	Professional	26	$25.41	$39.77	$78.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.47 / $61.74 / $120.77	Professional	TC	$38.47	$61.74	$120.77
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $40.69 / $40.69 / $40.69	Facility	26	$40.69	$40.69	$40.69
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $60.03 / $96.45 / $135.03	Professional		$60.03	$96.45	$135.03
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $23.94 / $39.11 / $53.40	Professional	26	$23.94	$39.11	$53.40
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $36.09 / $58.31 / $81.36	Professional	TC	$36.09	$58.31	$81.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.56 / $82.10 / $141.11	Professional		$36.56	$82.10	$141.11
United Facility/Professional Professional Modifier Low / Median / High Price $73.55 / $83.04 / $154.72	Professional		$73.55	$83.04	$154.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.15 / $31.58 / $70.81	Professional	26	$28.15	$31.58	$70.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.92 / $52.95 / $103.27	Professional	TC	$44.92	$52.95	$103.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $58.52 / $58.52 / $58.52	Professional		$58.52	$58.52	$58.52
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.31 / $22.31 / $22.31	Professional	26	$22.31	$22.31	$22.31
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $36.21 / $36.21 / $36.21	Professional	TC	$36.21	$36.21	$36.21