Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.04 / $31.52 / $86.98	Facility	26	$18.04	$31.52	$86.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.87 / $92.50 / $177.01	Professional		$62.87	$92.50	$177.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.04 / $24.57 / $50.03	Professional	26	$18.04	$24.57	$50.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.84 / $69.01 / $102.10	Professional	TC	$44.84	$69.01	$102.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.02 / $73.78 / $207.50	Professional		$59.02	$73.78	$207.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.38 / $37.95 / $54.21	Professional	26	$19.38	$37.95	$54.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.07 / $30.07 / $78.53	Facility	26	$30.07	$30.07	$78.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.40 / $98.57 / $181.90	Professional		$68.40	$98.57	$181.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.88 / $29.56 / $53.31	Professional	26	$18.88	$29.56	$53.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.52 / $70.73 / $139.08	Professional	TC	$49.52	$70.73	$139.08
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $28.60 / $28.60 / $28.60	Facility	26	$28.60	$28.60	$28.60
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $65.81 / $94.20 / $125.71	Professional		$65.81	$94.20	$125.71
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $18.80 / $28.60 / $37.54	Professional	26	$18.80	$28.60	$37.54
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $46.85 / $64.52 / $90.18	Professional	TC	$46.85	$64.52	$90.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.58 / $78.52 / $137.35	Professional		$35.58	$78.52	$137.35
United Facility/Professional Professional Modifier Low / Median / High Price $68.67 / $83.37 / $167.80	Professional		$68.67	$83.37	$167.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.28 / $23.56 / $50.21	Professional	26	$20.28	$23.56	$50.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.24 / $59.87 / $118.38	Professional	TC	$48.24	$59.87	$118.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.78 / $51.78 / $51.78	Professional		$51.78	$51.78	$51.78
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $13.51 / $13.51 / $13.51	Professional	26	$13.51	$13.51	$13.51
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $38.27 / $38.27 / $38.27	Professional	TC	$38.27	$38.27	$38.27