Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.08 / $75.08 / $75.08	Facility	26	$75.08	$75.08	$75.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.04 / $50.94 / $84.46	Professional		$38.04	$50.94	$84.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.37 / $21.49 / $58.27	Professional	26	$17.37	$21.49	$58.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.55 / $31.73 / $48.52	Professional	TC	$21.55	$31.73	$48.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.56 / $74.56 / $74.56	Professional		$74.56	$74.56	$74.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.94 / $13.00 / $42.44	Professional	26	$12.94	$13.00	$42.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.64 / $53.85 / $106.38	Professional		$33.64	$53.85	$106.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.52 / $23.53 / $44.53	Professional	26	$13.52	$23.53	$44.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.07 / $28.91 / $62.64	Professional	TC	$20.07	$28.91	$62.64
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $33.19 / $55.50 / $110.99	Professional		$33.19	$55.50	$110.99
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $20.03 / $30.91 / $38.83	Professional	26	$20.03	$30.91	$38.83
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $17.85 / $29.71 / $59.41	Professional	TC	$17.85	$29.71	$59.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.23 / $79.72 / $125.25	Professional		$41.23	$79.72	$125.25
United Facility/Professional Professional Modifier Low / Median / High Price $31.74 / $42.32 / $165.00	Professional		$31.74	$42.32	$165.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.31 / $17.35 / $70.02	Professional	26	$13.31	$17.35	$70.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.43 / $24.25 / $80.84	Professional	TC	$18.43	$24.25	$80.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.57 / $61.27 / $61.27	Professional		$27.57	$61.27	$61.27
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $20.68 / $20.68	Professional	26	$9.31	$20.68	$20.68
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $18.27 / $40.59 / $40.59	Professional	TC	$18.27	$40.59	$40.59