Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.28 / $27.58 / $105.55	Facility	26	$22.28	$27.58	$105.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.09 / $107.65 / $283.05	Professional		$70.09	$107.65	$283.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.28 / $32.24 / $87.79	Professional	26	$22.28	$32.24	$87.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.82 / $70.77 / $136.69	Professional	TC	$47.82	$70.77	$136.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.41 / $82.61 / $138.59	Professional		$66.41	$82.61	$138.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.96 / $30.90 / $68.31	Professional	26	$23.96	$30.90	$68.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $53.06 / $56.37 / $68.56	Professional	TC	$53.06	$56.37	$68.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.07 / $37.07 / $100.04	Facility	26	$37.07	$37.07	$100.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.50 / $111.05 / $221.94	Professional		$72.50	$111.05	$221.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.32 / $35.22 / $69.09	Professional	26	$23.32	$35.22	$69.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.18 / $77.28 / $151.60	Professional	TC	$49.18	$77.28	$151.60
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $36.81 / $36.81 / $36.81	Facility	26	$36.81	$36.81	$36.81
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $68.37 / $106.09 / $150.61	Professional		$68.37	$106.09	$150.61
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $21.94 / $36.81 / $48.31	Professional	26	$21.94	$36.81	$48.31
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $46.42 / $69.16 / $103.19	Professional	TC	$46.42	$69.16	$103.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.60 / $83.06 / $143.10	Professional		$36.60	$83.06	$143.10
United Facility/Professional Professional Modifier Low / Median / High Price $82.48 / $95.69 / $177.04	Professional		$82.48	$95.69	$177.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.11 / $29.10 / $58.26	Professional	26	$26.11	$29.10	$58.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.74 / $66.70 / $127.67	Professional	TC	$55.74	$66.70	$127.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.09 / $66.09 / $66.09	Professional		$66.09	$66.09	$66.09
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $20.07 / $20.07 / $20.07	Professional	26	$20.07	$20.07	$20.07
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $46.01 / $46.01 / $46.01	Professional	TC	$46.01	$46.01	$46.01