Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $67.61 / $67.61	Facility	26	$67.61	$67.61	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $56.23 / $102.33	Professional		$39.81	$56.23	$102.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $20.89 / $63.10	Professional	26	$15.14	$20.89	$63.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $34.67 / $70.79	Professional	TC	$23.99	$34.67	$70.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $38.90 / $38.90	Professional	26	$38.90	$38.90	$38.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $47.86 / $100.00	Professional		$29.51	$47.86	$100.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $20.89 / $39.81	Professional	26	$12.30	$20.89	$39.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $30.90 / $60.26	Professional	TC	$17.38	$30.90	$60.26
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $60.26 / $109.65	Professional		$38.02	$60.26	$109.65
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $28.84 / $45.71	Professional	26	$17.38	$28.84	$45.71
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $26.92 / $77.62	Professional	TC	$20.89	$26.92	$77.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $81.28	Professional		$32.36	$33.11	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $42.66 / $147.91	Professional		$31.62	$42.66	$147.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.85 / $63.10	Professional	26	$12.02	$15.85	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $26.30 / $87.10	Professional	TC	$18.62	$26.30	$87.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $60.26 / $60.26	Professional		$26.92	$60.26	$60.26
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $17.38 / $17.38	Professional	26	$7.94	$17.38	$17.38
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $42.66 / $42.66	Professional	TC	$19.05	$42.66	$42.66