Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.29 / $239.88	Facility	26	$51.29	$51.29	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $169.82 / $346.74	Professional		$134.90	$169.82	$346.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $83.18 / $213.80	Professional	26	$51.29	$83.18	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $120.23 / $218.78	Professional	TC	$67.61	$120.23	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $95.50 / $123.03	Professional		$83.18	$95.50	$123.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $87.10 / $120.23	Professional	26	$52.48	$87.10	$120.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $134.90	Facility	26	$16.98	$79.43	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $181.97 / $398.11	Professional		$97.72	$181.97	$398.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $64.57 / $147.91	Professional	26	$43.65	$64.57	$147.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $87.10 / $281.84	Professional	TC	$47.86	$87.10	$281.84
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $60.26 / $60.26	Facility	26	$60.26	$60.26	$60.26
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $281.84	Professional		$85.11	$141.25	$281.84
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $54.95 / $91.20	Professional	26	$45.71	$54.95	$91.20
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $67.61 / $125.89	Professional	TC	$39.81	$67.61	$125.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $52.48 / $131.83	Professional		$32.36	$52.48	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $144.54 / $302.00	Professional		$102.33	$144.54	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $60.26 / $107.15	Professional	26	$43.65	$60.26	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $77.62 / $194.98	Professional	TC	$53.70	$77.62	$194.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $120.23	Professional		$81.28	$81.28	$120.23
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $44.67 / $67.61	Professional	26	$44.67	$44.67	$67.61
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $37.15 / $53.70	Professional	TC	$37.15	$37.15	$53.70