Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.34 / $358.48 / $987.02	Facility		$131.34	$358.48	$987.02
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.23 / $30.04 / $92.09	Facility	26	$18.23	$30.04	$92.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.93 / $78.38 / $161.21	Professional		$73.93	$78.38	$161.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.23 / $25.10 / $68.84	Professional	26	$18.23	$25.10	$68.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.89 / $59.45 / $104.71	Professional	TC	$49.89	$59.45	$104.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.45 / $84.33 / $91.77	Professional		$67.45	$84.33	$91.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.55 / $29.55 / $51.16	Professional	26	$29.55	$29.55	$51.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.31 / $98.23 / $159.40	Facility		$69.31	$98.23	$159.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.05 / $83.92 / $165.29	Professional		$59.05	$83.92	$165.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.09 / $25.13 / $46.55	Professional	26	$19.09	$25.13	$46.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.02 / $64.18 / $116.37	Professional	TC	$39.02	$64.18	$116.37
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $92.42 / $178.58 / $280.69	Facility		$92.42	$178.58	$280.69
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $65.65 / $76.12 / $131.30	Professional		$65.65	$76.12	$131.30
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $17.91 / $19.18 / $33.74	Professional	26	$17.91	$19.18	$33.74
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $40.54 / $55.88 / $81.09	Professional	TC	$40.54	$55.88	$81.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.32 / $120.39 / $183.40	Professional		$36.32	$120.39	$183.40
United Facility/Professional Professional Modifier Low / Median / High Price $57.25 / $84.66 / $136.74	Professional		$57.25	$84.66	$136.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.46 / $23.56 / $37.31	Professional	26	$20.46	$23.56	$37.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.14 / $61.85 / $101.29	Professional	TC	$37.14	$61.85	$101.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $53.22 / $53.22 / $53.22	Professional		$53.22	$53.22	$53.22
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.08 / $12.08 / $12.08	Professional	26	$12.08	$12.08	$12.08
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $41.14 / $41.14 / $41.14	Professional	TC	$41.14	$41.14	$41.14