Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.44 / $86.56 / $406.17	Facility	26	$38.44	$86.56	$406.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.22 / $171.00 / $227.43	Professional		$104.22	$171.00	$227.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.50 / $51.30 / $75.84	Professional	26	$32.50	$51.30	$75.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.70 / $119.70 / $159.19	Professional	TC	$71.70	$119.70	$159.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.08 / $94.65 / $182.51	Professional		$89.08	$94.65	$182.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.95 / $45.93 / $71.59	Professional	26	$34.95	$45.93	$71.59
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $54.14 / $57.53 / $110.92	Professional	TC	$54.14	$57.53	$110.92
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $77.95 / $105.79 / $178.98	Professional		$77.95	$105.79	$178.98
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $30.58 / $34.95 / $60.67	Professional	26	$30.58	$34.95	$60.67
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $47.37 / $57.91 / $129.01	Professional	TC	$47.37	$57.91	$129.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.04 / $82.75 / $166.26	Professional		$36.04	$82.75	$166.26
United Facility/Professional Professional Modifier Low / Median / High Price $93.57 / $130.85 / $230.88	Professional		$93.57	$130.85	$230.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.50 / $37.75 / $71.15	Professional	26	$32.50	$37.75	$71.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.85 / $84.71 / $164.56	Professional	TC	$58.85	$84.71	$164.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $71.79 / $71.79 / $71.79	Professional		$71.79	$71.79	$71.79
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $26.59 / $26.59 / $26.59	Professional	26	$26.59	$26.59	$26.59
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $45.19 / $45.19 / $45.19	Professional	TC	$45.19	$45.19	$45.19