Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.48 / $53.63 / $129.36	Facility		$47.48	$53.63	$129.36
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.38 / $72.38 / $72.38	Facility	26	$72.38	$72.38	$72.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $96.02 / $96.02 / $110.02	Facility	TC	$96.02	$96.02	$110.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $59.35 / $90.46	Professional		$45.00	$59.35	$90.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.28 / $27.62 / $128.02	Professional	26	$17.28	$27.62	$128.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.96 / $33.21 / $51.15	Professional	TC	$25.96	$33.21	$51.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.05 / $33.95 / $62.72	Professional		$17.05	$33.95	$62.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $24.99 / $41.97	Professional	26	$12.59	$24.99	$41.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.88 / $34.88 / $35.08	Professional	TC	$34.88	$34.88	$35.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.44 / $55.73 / $140.00	Professional		$32.44	$55.73	$140.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.69 / $28.75 / $74.67	Professional	26	$13.69	$28.75	$74.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.04 / $32.03 / $67.61	Professional	TC	$19.04	$32.03	$67.61
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $63.15 / $91.96 / $136.47	Professional		$63.15	$91.96	$136.47
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $25.58 / $41.66 / $74.63	Professional	26	$25.58	$41.66	$74.63
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $31.58 / $45.29 / $79.69	Professional	TC	$31.58	$45.29	$79.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.40 / $45.60 / $83.59	Professional		$30.40	$45.60	$83.59
United Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $58.93 / $165.70	Professional		$32.11	$58.93	$165.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.15 / $25.98 / $80.08	Professional	26	$13.15	$25.98	$80.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.64 / $29.41 / $94.27	Professional	TC	$18.64	$29.41	$94.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.32 / $51.82 / $51.82	Professional		$23.32	$51.82	$51.82
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $20.42 / $20.42	Professional	26	$9.19	$20.42	$20.42
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $31.40 / $31.40	Professional	TC	$14.13	$31.40	$31.40