Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.94 / $40.70 / $59.00	Facility	26	$9.94	$40.70	$59.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.05 / $120.32 / $275.00	Professional		$75.05	$120.32	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.07 / $15.52 / $51.30	Professional	26	$10.07	$15.52	$51.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.46 / $102.81 / $165.74	Professional	TC	$63.46	$102.81	$165.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.90 / $10.90 / $10.90	Professional	26	$10.90	$10.90	$10.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $35.57	Facility	26	$13.50	$13.50	$35.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.04 / $149.22 / $257.37	Professional		$75.04	$149.22	$257.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $12.93 / $24.59	Professional	26	$8.27	$12.93	$24.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.55 / $126.61 / $240.45	Professional	TC	$66.55	$126.61	$240.45
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $12.90 / $12.90 / $12.90	Facility	26	$12.90	$12.90	$12.90
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $82.84 / $125.58 / $162.71	Professional		$82.84	$125.58	$162.71
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $13.28 / $16.93	Professional	26	$9.02	$13.28	$16.93
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $72.73 / $113.73 / $142.82	Professional	TC	$72.73	$113.73	$142.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.36 / $100.46 / $167.24	Professional		$58.36	$100.46	$167.24
United Facility/Professional Professional Modifier Low / Median / High Price $84.56 / $116.21 / $210.38	Professional		$84.56	$116.21	$210.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.90 / $10.36 / $21.37	Professional	26	$8.90	$10.36	$21.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.59 / $103.58 / $190.07	Professional	TC	$74.59	$103.58	$190.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.73 / $66.73 / $66.73	Professional		$66.73	$66.73	$66.73
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.53 / $7.53 / $7.53	Professional	26	$7.53	$7.53	$7.53
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $59.20 / $59.20 / $59.20	Professional	TC	$59.20	$59.20	$59.20