Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.23 / $41.89 / $126.81	Facility	26	$27.23	$41.89	$126.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.80 / $133.53 / $269.80	Professional		$86.80	$133.53	$269.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.12 / $41.11 / $101.50	Professional	26	$31.12	$41.11	$101.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.22 / $91.65 / $142.47	Professional	TC	$64.22	$91.65	$142.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.02 / $94.29 / $192.14	Professional		$75.02	$94.29	$192.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.15 / $39.40 / $70.02	Professional	26	$28.15	$39.40	$70.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $62.89 / $64.31 / $101.06	Professional	TC	$62.89	$64.31	$101.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.97 / $43.97 / $114.59	Facility	26	$43.97	$43.97	$114.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.60 / $144.60 / $249.57	Professional		$85.60	$144.60	$249.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.06 / $44.74 / $78.13	Professional	26	$27.06	$44.74	$78.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.54 / $102.07 / $181.26	Professional	TC	$58.54	$102.07	$181.26
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $48.41 / $48.41 / $48.41	Facility	26	$48.41	$48.41	$48.41
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $87.92 / $152.19 / $213.07	Professional		$87.92	$152.19	$213.07
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $27.35 / $45.65 / $63.54	Professional	26	$27.35	$45.65	$63.54
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $60.23 / $106.80 / $149.52	Professional	TC	$60.23	$106.80	$149.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.07 / $106.86 / $185.34	Professional		$37.07	$106.86	$185.34
United Facility/Professional Professional Modifier Low / Median / High Price $100.73 / $128.04 / $238.04	Professional		$100.73	$128.04	$238.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.76 / $39.18 / $78.51	Professional	26	$30.76	$39.18	$78.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.84 / $85.94 / $164.00	Professional	TC	$69.84	$85.94	$164.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $73.15 / $73.15 / $73.15	Professional		$73.15	$73.15	$73.15
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.18 / $22.18 / $22.18	Professional	26	$22.18	$22.18	$22.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $50.97 / $50.97 / $50.97	Professional	TC	$50.97	$50.97	$50.97