Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.61 / $18.95 / $75.08	Facility	26	$15.61	$18.95	$75.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.08 / $174.04 / $307.22	Professional		$151.08	$174.04	$307.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.61 / $18.01 / $35.29	Professional	26	$15.61	$18.01	$35.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $135.47 / $155.41 / $251.47	Professional	TC	$135.47	$155.41	$251.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $124.03 / $141.76 / $443.00	Professional		$124.03	$141.76	$443.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $32.90 / $48.53	Professional	26	$17.82	$32.90	$48.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $26.30 / $26.30	Facility	26	$26.30	$26.30	$26.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.94 / $278.86 / $422.38	Professional		$149.94	$278.86	$422.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.34 / $29.02 / $42.90	Professional	26	$16.34	$29.02	$42.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $133.60 / $249.44 / $386.10	Professional	TC	$133.60	$249.44	$386.10
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $137.83 / $157.52 / $325.33	Professional		$137.83	$157.52	$325.33
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $15.60 / $17.10 / $34.69	Professional	26	$15.60	$17.10	$34.69
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $122.22 / $139.68 / $292.30	Professional	TC	$122.22	$139.68	$292.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.97 / $213.05 / $363.31	Professional		$35.97	$213.05	$363.31
United Facility/Professional Professional Modifier Low / Median / High Price $183.65 / $205.79 / $434.27	Professional		$183.65	$205.79	$434.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.63 / $21.45 / $43.07	Professional	26	$18.63	$21.45	$43.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.91 / $184.65 / $372.45	Professional	TC	$165.91	$184.65	$372.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $148.81 / $148.81 / $148.81	Professional		$148.81	$148.81	$148.81
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $15.50 / $15.50 / $15.50	Professional	26	$15.50	$15.50	$15.50
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $133.31 / $133.31 / $133.31	Professional	TC	$133.31	$133.31	$133.31