Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.16 / $22.03 / $91.57	Facility	26	$19.16	$22.03	$91.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.25 / $94.06 / $150.26	Professional		$68.25	$94.06	$150.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.16 / $26.33 / $50.36	Professional	26	$19.16	$26.33	$50.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $67.43 / $110.33	Professional	TC	$49.10	$67.43	$110.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.14 / $78.70 / $118.06	Professional		$66.14	$78.70	$118.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $26.40 / $51.24	Professional	26	$20.89	$26.40	$51.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $32.36 / $32.36	Facility	26	$32.36	$32.36	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.23 / $111.73 / $216.06	Professional		$71.23	$111.73	$216.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.28 / $32.26 / $62.35	Professional	26	$20.28	$32.26	$62.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.96 / $80.70 / $161.80	Professional	TC	$50.96	$80.70	$161.80
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $31.88 / $31.88 / $31.88	Facility	26	$31.88	$31.88	$31.88
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $68.87 / $106.05 / $147.04	Professional		$68.87	$106.05	$147.04
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $19.25 / $30.77 / $41.84	Professional	26	$19.25	$30.77	$41.84
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $49.62 / $75.28 / $105.21	Professional	TC	$49.62	$75.28	$105.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.66 / $94.29 / $180.86	Professional		$39.66	$94.29	$180.86
United Facility/Professional Professional Modifier Low / Median / High Price $80.54 / $90.81 / $167.19	Professional		$80.54	$90.81	$167.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.22 / $26.29 / $55.87	Professional	26	$23.22	$26.29	$55.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.86 / $64.81 / $122.69	Professional	TC	$57.86	$64.81	$122.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.51 / $87.51 / $87.51	Professional		$87.51	$87.51	$87.51
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $23.46 / $23.46	Professional	26	$23.46	$23.46	$23.46
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $64.04 / $64.04 / $64.04	Professional	TC	$64.04	$64.04	$64.04