Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.71 / $25.63 / $98.03	Facility	26	$20.71	$25.63	$98.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.04 / $99.00 / $250.13	Professional		$67.04	$99.00	$250.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.72 / $30.33 / $110.82	Professional	26	$20.72	$30.33	$110.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.33 / $65.12 / $136.65	Professional	TC	$46.33	$65.12	$136.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.25 / $78.25 / $141.61	Professional		$63.25	$78.25	$141.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.18 / $27.79 / $61.67	Professional	26	$22.18	$27.79	$61.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $48.28 / $54.37 / $83.06	Professional	TC	$48.28	$54.37	$83.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $34.36 / $93.01	Facility	26	$34.36	$34.36	$93.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.30 / $98.02 / $206.50	Professional		$69.30	$98.02	$206.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.69 / $32.90 / $64.05	Professional	26	$21.69	$32.90	$64.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.29 / $66.20 / $147.50	Professional	TC	$44.29	$66.20	$147.50
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $34.28 / $34.28 / $34.28	Facility	26	$34.28	$34.28	$34.28
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $54.84 / $84.33 / $122.69	Professional		$54.84	$84.33	$122.69
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $20.38 / $33.42 / $44.52	Professional	26	$20.38	$33.42	$44.52
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $31.52 / $47.05 / $78.45	Professional	TC	$31.52	$47.05	$78.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.74 / $82.37 / $142.48	Professional		$35.74	$82.37	$142.48
United Facility/Professional Professional Modifier Low / Median / High Price $59.07 / $93.30 / $160.25	Professional		$59.07	$93.30	$160.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.30 / $26.82 / $49.62	Professional	26	$24.30	$26.82	$49.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.22 / $65.37 / $106.42	Professional	TC	$33.22	$65.37	$106.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $46.26 / $46.26 / $46.26	Professional		$46.26	$46.26	$46.26
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $13.72 / $13.72 / $13.72	Professional	26	$13.72	$13.72	$13.72
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $32.53 / $32.53 / $32.53	Professional	TC	$32.53	$32.53	$32.53