Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.41 / $35.28 / $339.26	Facility	26	$21.41	$35.28	$339.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.18 / $121.32 / $268.52	Professional		$88.18	$121.32	$268.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.41 / $30.30 / $61.04	Professional	26	$21.41	$30.30	$61.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.77 / $87.95 / $151.84	Professional	TC	$66.77	$87.95	$151.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.91 / $150.68 / $214.35	Professional		$115.91	$150.68	$214.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.70 / $40.13 / $50.94	Professional	26	$24.70	$40.13	$50.94
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $55.45 / $55.45 / $148.58	Professional	TC	$55.45	$55.45	$148.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.04 / $37.04 / $97.21	Facility	26	$37.04	$37.04	$97.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.30 / $143.69 / $309.99	Professional		$79.30	$143.69	$309.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.41 / $35.79 / $70.00	Professional	26	$22.41	$35.79	$70.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.18 / $113.93 / $255.59	Professional	TC	$65.18	$113.93	$255.59
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $34.82 / $34.82 / $34.82	Facility	26	$34.82	$34.82	$34.82
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $74.41 / $113.70 / $169.54	Professional		$74.41	$113.70	$169.54
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $21.61 / $35.63 / $45.70	Professional	26	$21.61	$35.63	$45.70
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $48.29 / $75.66 / $124.67	Professional	TC	$48.29	$75.66	$124.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.60 / $125.08 / $233.28	Professional		$36.60	$125.08	$233.28
United Facility/Professional Professional Modifier Low / Median / High Price $77.95 / $122.46 / $220.16	Professional		$77.95	$122.46	$220.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.58 / $28.96 / $51.44	Professional	26	$25.58	$28.96	$51.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.65 / $95.18 / $168.95	Professional	TC	$50.65	$95.18	$168.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $56.83 / $56.83 / $56.83	Professional		$56.83	$56.83	$56.83
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $9.02 / $9.02	Professional	26	$9.02	$9.02	$9.02
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $47.79 / $47.79 / $47.79	Professional	TC	$47.79	$47.79	$47.79