Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.48 / $47.48 / $47.48	Facility		$47.48	$47.48	$47.48
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $185.32 / $185.32 / $185.32	Facility	26	$185.32	$185.32	$185.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.01 / $111.30 / $207.40	Professional		$82.01	$111.30	$207.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.38 / $68.00 / $356.40	Professional	26	$43.38	$68.00	$356.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.27 / $59.59 / $121.95	Professional	TC	$41.27	$59.59	$121.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.06 / $86.20 / $195.59	Professional		$77.06	$86.20	$195.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $62.98 / $105.66	Professional	26	$13.00	$62.98	$105.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.87 / $120.10 / $227.91	Professional		$73.87	$120.10	$227.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.45 / $58.55 / $111.32	Professional	26	$34.45	$58.55	$111.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.65 / $61.16 / $120.34	Professional	TC	$37.65	$61.16	$120.34
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $78.33 / $120.46 / $240.01	Professional		$78.33	$120.46	$240.01
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $49.71 / $76.97 / $96.69	Professional	26	$49.71	$76.97	$96.69
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $24.08 / $56.34 / $115.18	Professional	TC	$24.08	$56.34	$115.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $67.30 / $109.68 / $206.53	Professional		$67.30	$109.68	$206.53
United Facility/Professional Facility Modifier Low / Median / High Price $44.52 / $44.52 / $44.52	Facility		$44.52	$44.52	$44.52
United Facility/Professional Professional Modifier Low / Median / High Price $71.77 / $91.42 / $343.30	Professional		$71.77	$91.42	$343.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.76 / $43.91 / $182.95	Professional	26	$33.76	$43.91	$182.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.51 / $47.99 / $174.21	Professional	TC	$37.51	$47.99	$174.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $59.05 / $131.22 / $131.22	Professional		$59.05	$131.22	$131.22
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.21 / $51.57 / $51.57	Professional	26	$23.21	$51.57	$51.57
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $35.84 / $79.65 / $79.65	Professional	TC	$35.84	$79.65	$79.65