Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $35.48 / $338.84	Facility	26	$20.89	$35.48	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $158.49 / $398.11	Professional		$91.20	$158.49	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $37.15 / $109.65	Professional	26	$21.38	$37.15	$109.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $93.33 / $190.55	Professional	TC	$66.07	$93.33	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $151.36 / $263.03	Professional		$91.20	$151.36	$263.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $31.62 / $50.12	Professional	26	$24.55	$31.62	$50.12
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $85.11 / $154.88	Professional	TC	$54.95	$85.11	$154.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $37.15 / $63.10	Facility	26	$7.94	$37.15	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $141.25 / $316.23	Professional		$74.13	$141.25	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $36.31 / $70.79	Professional	26	$22.39	$36.31	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $114.82 / $263.03	Professional	TC	$61.66	$114.82	$263.03
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $34.67 / $34.67	Facility	26	$34.67	$34.67	$34.67
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $147.91	Professional		$70.79	$100.00	$147.91
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $30.90 / $46.77	Professional	26	$22.39	$30.90	$46.77
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $66.07 / $102.33	Professional	TC	$44.67	$66.07	$102.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $43.65 / $102.33	Professional		$15.14	$43.65	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $123.03 / $218.78	Professional		$75.86	$123.03	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $29.51 / $53.70	Professional	26	$25.70	$29.51	$53.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $95.50 / $169.82	Professional	TC	$48.98	$95.50	$169.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $117.49	Professional		$63.10	$63.10	$117.49
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $10.23 / $31.62	Professional	26	$10.23	$10.23	$31.62
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $52.48 / $85.11	Professional	TC	$52.48	$52.48	$85.11