Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.48 / $19.88 / $60.35	Facility	26	$12.48	$19.88	$60.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.19 / $96.48 / $150.02	Professional		$65.19	$96.48	$150.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.48 / $17.67 / $55.99	Professional	26	$12.48	$17.67	$55.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.72 / $76.97 / $119.78	Professional	TC	$52.72	$76.97	$119.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.06 / $72.06 / $78.98	Professional		$72.06	$72.06	$78.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.73 / $18.54 / $31.25	Professional	26	$13.73	$18.54	$31.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.50 / $20.50 / $54.49	Facility	26	$20.50	$20.50	$54.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.23 / $91.54 / $181.18	Professional		$68.23	$91.54	$181.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.84 / $19.64 / $36.70	Professional	26	$12.84	$19.64	$36.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.64 / $71.64 / $149.63	Professional	TC	$55.64	$71.64	$149.63
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $20.29 / $20.29 / $20.29	Facility	26	$20.29	$20.29	$20.29
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $63.05 / $87.98 / $124.98	Professional		$63.05	$87.98	$124.98
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $13.38 / $20.29 / $26.63	Professional	26	$13.38	$20.29	$26.63
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $50.56 / $68.88 / $98.15	Professional	TC	$50.56	$68.88	$98.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $68.43 / $110.04	Professional		$40.00	$68.43	$110.04
United Facility/Professional Professional Modifier Low / Median / High Price $62.54 / $81.92 / $156.38	Professional		$62.54	$81.92	$156.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.22 / $16.04 / $32.64	Professional	26	$14.22	$16.04	$32.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.57 / $65.93 / $125.13	Professional	TC	$46.57	$65.93	$125.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.33 / $50.33 / $50.33	Professional		$50.33	$50.33	$50.33
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.01 / $9.01 / $9.01	Professional	26	$9.01	$9.01	$9.01
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $41.31 / $41.31 / $41.31	Professional	TC	$41.31	$41.31	$41.31