Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.30 / $77.73 / $245.74	Facility	26	$51.30	$77.73	$245.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.87 / $171.00 / $275.00	Professional		$137.87	$171.00	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $60.00 / $169.87	Professional	26	$51.30	$60.00	$169.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.84 / $119.70 / $192.00	Professional	TC	$68.84	$119.70	$192.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.40 / $83.57 / $102.84	Professional		$76.40	$83.57	$102.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.27 / $86.98 / $144.55	Professional	26	$51.27	$86.98	$144.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.31 / $79.31 / $166.59	Facility	26	$79.31	$79.31	$166.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.01 / $161.71 / $390.21	Professional		$98.01	$161.71	$390.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.55 / $63.95 / $130.88	Professional	26	$43.55	$63.95	$130.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.28 / $81.03 / $267.63	Professional	TC	$48.28	$81.03	$267.63
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $60.70 / $60.70 / $60.70	Facility	26	$60.70	$60.70	$60.70
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $90.89 / $150.94 / $314.88	Professional		$90.89	$150.94	$314.88
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $46.29 / $62.98 / $88.67	Professional	26	$46.29	$62.98	$88.67
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $47.22 / $76.06 / $231.35	Professional	TC	$47.22	$76.06	$231.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.27 / $91.21 / $172.00	Professional		$54.27	$91.21	$172.00
United Facility/Professional Professional Modifier Low / Median / High Price $101.40 / $142.91 / $292.43	Professional		$101.40	$142.91	$292.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.93 / $60.86 / $106.31	Professional	26	$43.93	$60.86	$106.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.42 / $74.59 / $180.86	Professional	TC	$52.42	$74.59	$180.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $73.87 / $73.87 / $73.87	Professional		$73.87	$73.87	$73.87
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $36.31 / $36.31	Professional	26	$36.31	$36.31	$36.31
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $37.54 / $37.54 / $37.54	Professional	TC	$37.54	$37.54	$37.54