Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.10 / $51.26 / $201.75	Facility	26	$39.10	$51.26	$201.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.31 / $130.22 / $322.45	Professional		$80.31	$130.22	$322.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.10 / $59.80 / $439.85	Professional	26	$39.10	$59.80	$439.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.22 / $63.85 / $121.65	Professional	TC	$41.22	$63.85	$121.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.90 / $100.84 / $194.45	Professional		$94.90	$100.84	$194.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.60 / $69.90 / $96.95	Professional	26	$46.60	$69.90	$96.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.78 / $68.78 / $68.78	Facility	26	$68.78	$68.78	$68.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.62 / $165.34 / $271.22	Professional		$97.62	$165.34	$271.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.18 / $75.65 / $108.70	Professional	26	$48.18	$75.65	$108.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.76 / $92.34 / $167.41	Professional	TC	$52.76	$92.34	$167.41
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $83.04 / $89.33 / $200.74	Professional		$83.04	$89.33	$200.74
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $40.78 / $43.69 / $75.38	Professional	26	$40.78	$43.69	$75.38
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $42.26 / $46.38 / $131.31	Professional	TC	$42.26	$46.38	$131.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $52.22 / $82.40 / $163.06	Professional		$52.22	$82.40	$163.06
United Facility/Professional Professional Modifier Low / Median / High Price $101.17 / $151.75 / $237.27	Professional		$101.17	$151.75	$237.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.04 / $64.86 / $106.76	Professional	26	$49.04	$64.86	$106.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.20 / $86.40 / $145.35	Professional	TC	$51.20	$86.40	$145.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $78.00 / $78.00 / $78.00	Professional		$78.00	$78.00	$78.00
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $37.24 / $37.24 / $37.24	Professional	26	$37.24	$37.24	$37.24
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $40.76 / $40.76 / $40.76	Professional	TC	$40.76	$40.76	$40.76