Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.90 / $494.51 / $1,067.43	Facility		$64.90	$494.51	$1,067.43
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.54 / $36.36 / $323.41	Facility	26	$20.54	$36.36	$323.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.47 / $61.27 / $232.11	Professional		$37.47	$61.27	$232.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.54 / $30.80 / $105.05	Professional	26	$20.54	$30.80	$105.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.94 / $27.11 / $170.38	Professional	TC	$16.94	$27.11	$170.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.85 / $48.10 / $91.46	Professional		$41.85	$48.10	$91.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.49 / $37.93 / $55.22	Professional	26	$22.49	$37.93	$55.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $101.24 / $154.07	Facility		$66.70	$101.24	$154.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.51 / $34.51 / $93.65	Facility	26	$34.51	$34.51	$93.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.36 / $79.34 / $250.36	Professional		$40.36	$79.34	$250.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.51 / $34.67 / $67.45	Professional	26	$21.51	$34.67	$67.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.85 / $35.96 / $177.09	Professional	TC	$18.85	$35.96	$177.09
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $206.03 / $330.24	Facility		$102.33	$206.03	$330.24
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $34.00 / $34.00 / $34.00	Facility	26	$34.00	$34.00	$34.00
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $42.08 / $75.15 / $152.13	Professional		$42.08	$75.15	$152.13
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $34.58 / $45.52	Professional	26	$20.42	$34.58	$45.52
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $20.45 / $35.04 / $69.75	Professional	TC	$20.45	$35.04	$69.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.72 / $49.17 / $90.47	Professional		$29.72	$49.17	$90.47
United Facility/Professional Professional Modifier Low / Median / High Price $45.81 / $68.70 / $185.35	Professional		$45.81	$68.70	$185.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.39 / $27.60 / $51.69	Professional	26	$24.39	$27.60	$51.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.79 / $31.08 / $136.38	Professional	TC	$19.79	$31.08	$136.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.21 / $62.21 / $62.21	Professional		$62.21	$62.21	$62.21
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $31.82 / $31.82 / $31.82	Professional	26	$31.82	$31.82	$31.82
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $30.39 / $30.39 / $30.39	Professional	TC	$30.39	$30.39	$30.39