Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.59 / $47.23 / $194.41	Facility	26	$37.59	$47.23	$194.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.33 / $131.38 / $310.58	Professional		$113.33	$131.38	$310.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.59 / $44.84 / $106.02	Professional	26	$37.59	$44.84	$106.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.73 / $87.39 / $149.22	Professional	TC	$75.73	$87.39	$149.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.61 / $131.30 / $369.27	Professional		$102.61	$131.30	$369.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.30 / $72.73 / $114.36	Professional	26	$42.30	$72.73	$114.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.82 / $63.82 / $63.82	Facility	26	$63.82	$63.82	$63.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.64 / $211.54 / $338.75	Professional		$118.64	$211.54	$338.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.00 / $68.95 / $102.01	Professional	26	$39.00	$68.95	$102.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.64 / $139.86 / $244.07	Professional	TC	$79.64	$139.86	$244.07
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $114.88 / $131.30 / $269.05	Professional		$114.88	$131.30	$269.05
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $37.57 / $42.94 / $82.16	Professional	26	$37.57	$42.94	$82.16
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $77.31 / $88.36 / $196.19	Professional	TC	$77.31	$88.36	$196.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $144.11 / $246.35	Professional		$38.90	$144.11	$246.35
United Facility/Professional Professional Modifier Low / Median / High Price $134.47 / $164.65 / $324.14	Professional		$134.47	$164.65	$324.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.99 / $49.90 / $98.11	Professional	26	$43.99	$49.90	$98.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.47 / $117.78 / $212.49	Professional	TC	$90.47	$117.78	$212.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.98 / $107.98 / $107.98	Professional		$107.98	$107.98	$107.98
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.94 / $33.94 / $33.94	Professional	26	$33.94	$33.94	$33.94
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $74.04 / $74.04 / $74.04	Professional	TC	$74.04	$74.04	$74.04