Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.02 / $68.02 / $68.02	Facility	26	$68.02	$68.02	$68.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.61 / $50.78 / $71.58	Professional		$31.61	$50.78	$71.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.34 / $19.48 / $62.84	Professional	26	$15.34	$19.48	$62.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.32 / $31.29 / $46.33	Professional	TC	$17.32	$31.29	$46.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.57 / $37.57 / $37.57	Professional		$37.57	$37.57	$37.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.26 / $39.26 / $39.26	Professional	26	$39.26	$39.26	$39.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.91 / $52.26 / $106.00	Professional		$29.91	$52.26	$106.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.54 / $21.39 / $40.68	Professional	26	$12.54	$21.39	$40.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.28 / $29.09 / $66.43	Professional	TC	$18.28	$29.09	$66.43
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $30.35 / $54.20 / $94.24	Professional		$30.35	$54.20	$94.24
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $17.69 / $28.59 / $35.92	Professional	26	$17.69	$28.59	$35.92
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $26.33 / $64.55	Professional	TC	$19.50	$26.33	$64.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.24 / $79.72 / $125.25	Professional		$41.24	$79.72	$125.25
United Facility/Professional Professional Modifier Low / Median / High Price $30.19 / $42.37 / $153.82	Professional		$30.19	$42.37	$153.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.34 / $16.20 / $64.18	Professional	26	$12.34	$16.20	$64.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.83 / $26.64 / $90.94	Professional	TC	$15.83	$26.64	$90.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.78 / $61.74 / $61.74	Professional		$27.78	$61.74	$61.74
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.33 / $18.52 / $18.52	Professional	26	$8.33	$18.52	$18.52
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.45 / $43.22 / $43.22	Professional	TC	$19.45	$43.22	$43.22