Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.54 / $51.61 / $154.75	Facility	26	$33.54	$51.61	$154.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.47 / $168.63 / $290.75	Professional		$120.47	$168.63	$290.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.43 / $50.32 / $120.60	Professional	26	$38.43	$50.32	$120.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.11 / $117.01 / $181.71	Professional	TC	$82.11	$117.01	$181.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.94 / $117.91 / $286.57	Professional		$92.94	$117.91	$286.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.79 / $52.45 / $97.36	Professional	26	$34.79	$52.45	$97.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $80.14 / $95.06 / $95.06	Professional	TC	$80.14	$95.06	$95.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $142.09	Facility	26	$54.02	$54.02	$142.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.72 / $183.47 / $317.02	Professional		$107.72	$183.47	$317.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.13 / $55.31 / $96.01	Professional	26	$33.13	$55.31	$96.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.59 / $130.60 / $231.90	Professional	TC	$74.59	$130.60	$231.90
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $60.14 / $60.14 / $60.14	Facility	26	$60.14	$60.14	$60.14
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $110.54 / $192.92 / $270.08	Professional		$110.54	$192.92	$270.08
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $33.28 / $56.71 / $78.93	Professional	26	$33.28	$56.71	$78.93
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $76.65 / $136.54 / $191.15	Professional	TC	$76.65	$136.54	$191.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $119.59 / $216.14	Professional		$37.20	$119.59	$216.14
United Facility/Professional Professional Modifier Low / Median / High Price $125.73 / $156.15 / $291.14	Professional		$125.73	$156.15	$291.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.18 / $48.18 / $90.18	Professional	26	$38.18	$48.18	$90.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.48 / $109.83 / $208.97	Professional	TC	$89.48	$109.83	$208.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $92.95 / $92.95 / $92.95	Professional		$92.95	$92.95	$92.95
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.34 / $27.34 / $27.34	Professional	26	$27.34	$27.34	$27.34
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $65.61 / $65.61 / $65.61	Professional	TC	$65.61	$65.61	$65.61