Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $102.33 / $338.84	Facility	26	$61.66	$102.33	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $131.83 / $275.42	Professional		$95.50	$131.83	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $44.67 / $95.50	Professional	TC	$33.11	$44.67	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $144.54	Professional		$112.20	$112.20	$144.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.39 / $104.71 / $151.36	Facility	26	$22.39	$104.71	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $154.88 / $281.84	Professional		$102.33	$154.88	$281.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $52.48 / $125.89	Professional	TC	$36.31	$52.48	$125.89
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $109.65 / $223.87	Professional		$97.72	$109.65	$223.87
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $39.81 / $107.15	Professional	TC	$35.48	$39.81	$107.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $61.66 / $147.91	Professional		$32.36	$61.66	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $141.25 / $245.47	Professional		$114.82	$141.25	$245.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $52.48 / $100.00	Professional	TC	$38.02	$52.48	$100.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $141.25	Professional		$95.50	$95.50	$141.25
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $34.67 / $51.29	Professional	TC	$34.67	$34.67	$51.29