Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.84 / $91.09 / $356.04	Facility	26	$69.84	$91.09	$356.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.14 / $141.26 / $265.89	Professional		$86.14	$141.26	$265.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.84 / $96.01 / $228.50	Professional	26	$69.84	$96.01	$228.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.30 / $27.47 / $110.68	Professional	TC	$16.30	$27.47	$110.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.54 / $118.52 / $228.54	Professional		$111.54	$118.52	$228.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.81 / $134.56 / $172.76	Professional	26	$82.81	$134.56	$172.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $121.50 / $121.50 / $121.50	Facility	26	$121.50	$121.50	$121.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.27 / $190.11 / $513.67	Professional		$113.27	$190.11	$513.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.13 / $130.76 / $192.33	Professional	26	$85.13	$130.76	$192.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.14 / $45.45 / $342.38	Professional	TC	$25.14	$45.45	$342.38
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $97.60 / $104.57 / $545.96	Professional		$97.60	$104.57	$545.96
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $72.45 / $77.64 / $127.43	Professional	26	$72.45	$77.64	$127.43
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $25.14 / $27.87 / $418.94	Professional	TC	$25.14	$27.87	$418.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.58 / $102.80 / $168.03	Professional		$30.58	$102.80	$168.03
United Facility/Professional Professional Modifier Low / Median / High Price $107.98 / $188.05 / $442.74	Professional		$107.98	$188.05	$442.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.02 / $110.65 / $182.99	Professional	26	$85.02	$110.65	$182.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.79 / $38.97 / $307.88	Professional	TC	$19.79	$38.97	$307.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $82.78 / $82.78 / $82.78	Professional		$82.78	$82.78	$82.78
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $61.79 / $61.79 / $61.79	Professional	26	$61.79	$61.79	$61.79
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $20.99 / $20.99 / $20.99	Professional	TC	$20.99	$20.99	$20.99