Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $223.94 / $223.94 / $223.94	Facility	26	$223.94	$223.94	$223.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.33 / $88.05 / $154.08	Professional		$80.33	$88.05	$154.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.41 / $71.29 / $175.51	Professional	26	$53.41	$71.29	$175.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.42 / $32.47 / $52.43	Professional	TC	$21.42	$32.47	$52.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.72 / $57.72 / $57.72	Professional		$57.72	$57.72	$57.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $99.32 / $134.40 / $134.40	Professional	26	$99.32	$134.40	$134.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.52 / $93.03 / $193.71	Professional		$57.52	$93.03	$193.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.40 / $72.33 / $137.22	Professional	26	$42.40	$72.33	$137.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.83 / $29.76 / $66.84	Professional	TC	$13.83	$29.76	$66.84
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $102.11 / $129.93 / $164.81	Professional		$102.11	$129.93	$164.81
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $61.85 / $82.34 / $159.87	Professional	26	$61.85	$82.34	$159.87
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $41.30 / $54.41	Professional	TC	$27.54	$41.30	$54.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.59 / $105.08 / $165.46	Professional		$32.59	$105.08	$165.46
United Facility/Professional Professional Modifier Low / Median / High Price $53.48 / $82.93 / $288.38	Professional		$53.48	$82.93	$288.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.26 / $53.96 / $212.03	Professional	26	$41.26	$53.96	$212.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.22 / $25.42 / $63.55	Professional	TC	$12.22	$25.42	$63.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.97 / $88.84 / $88.84	Professional		$39.97	$88.84	$88.84
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $29.64 / $65.86 / $65.86	Professional	26	$29.64	$65.86	$65.86
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $10.34 / $22.98 / $22.98	Professional	TC	$10.34	$22.98	$22.98