Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $64.57 / $208.93	Facility	26	$38.90	$64.57	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $158.49 / $776.25	Professional		$83.18	$158.49	$776.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $102.33 / $831.76	Professional	26	$39.81	$102.33	$831.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $70.79 / $158.49	Professional	TC	$41.69	$70.79	$158.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $104.71 / $190.55	Professional		$93.33	$104.71	$190.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $63.10 / $102.33	Professional	26	$46.77	$63.10	$102.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $69.18 / $97.72	Facility	26	$14.79	$69.18	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $169.82 / $288.40	Professional		$102.33	$169.82	$288.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $75.86 / $117.49	Professional	26	$48.98	$75.86	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $95.50 / $173.78	Professional	TC	$53.70	$95.50	$173.78
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $93.33 / $213.80	Professional		$87.10	$93.33	$213.80
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $44.67 / $75.86	Professional	26	$41.69	$44.67	$75.86
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $47.86 / $141.25	Professional	TC	$44.67	$47.86	$141.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $48.98 / $120.23	Professional		$32.36	$48.98	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $151.36 / $234.42	Professional		$102.33	$151.36	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $63.10 / $107.15	Professional	26	$48.98	$63.10	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $83.18 / $141.25	Professional	TC	$51.29	$83.18	$141.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $123.03	Professional		$85.11	$85.11	$123.03
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $40.74 / $60.26	Professional	26	$40.74	$40.74	$60.26
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $63.10	Professional	TC	$44.67	$44.67	$63.10