Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.56 / $49.78 / $159.85	Facility	26	$30.56	$49.78	$159.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.94 / $167.25 / $280.83	Professional		$144.94	$167.25	$280.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.56 / $35.26 / $61.61	Professional	26	$30.56	$35.26	$61.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.39 / $131.99 / $230.90	Professional	TC	$114.39	$131.99	$230.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.04 / $153.18 / $313.85	Professional		$134.04	$153.18	$313.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.40 / $63.48 / $96.92	Professional	26	$38.40	$63.48	$96.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.16 / $52.16 / $52.16	Facility	26	$52.16	$52.16	$52.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.40 / $270.56 / $414.45	Professional		$144.40	$270.56	$414.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.98 / $56.84 / $82.95	Professional	26	$31.98	$56.84	$82.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.42 / $218.12 / $336.04	Professional	TC	$112.42	$218.12	$336.04
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $134.03 / $153.18 / $307.68	Professional		$134.03	$153.18	$307.68
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $30.54 / $34.90 / $66.65	Professional	26	$30.54	$34.90	$66.65
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $103.49 / $118.28 / $248.44	Professional	TC	$103.49	$118.28	$248.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.10 / $177.54 / $305.67	Professional		$37.10	$177.54	$305.67
United Facility/Professional Professional Modifier Low / Median / High Price $176.34 / $211.22 / $395.81	Professional		$176.34	$211.22	$395.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.71 / $41.22 / $77.98	Professional	26	$35.71	$41.22	$77.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.26 / $169.93 / $315.30	Professional	TC	$140.26	$169.93	$315.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $140.61 / $140.61 / $140.61	Professional		$140.61	$140.61	$140.61
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $30.08 / $30.08 / $30.08	Professional	26	$30.08	$30.08	$30.08
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $110.53 / $110.53 / $110.53	Professional	TC	$110.53	$110.53	$110.53