Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $229.09 / $229.09 / $229.09	Facility	26	$229.09	$229.09	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $100.00 / $323.59	Professional		$85.11	$100.00	$323.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $93.33 / $234.42	Professional	26	$63.10	$93.33	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $32.36 / $61.66	Professional	TC	$19.95	$32.36	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $69.18	Professional		$57.54	$57.54	$69.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $134.90 / $144.54	Professional	26	$40.74	$134.90	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $91.20 / $199.53	Professional		$57.54	$91.20	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $72.44 / $138.04	Professional	26	$42.66	$72.44	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $29.51 / $67.61	Professional	TC	$13.49	$29.51	$67.61
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $131.83 / $257.04	Professional		$102.33	$131.83	$257.04
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $83.18 / $158.49	Professional	26	$61.66	$83.18	$158.49
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $45.71 / $100.00	Professional	TC	$28.84	$45.71	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $120.23	Professional		$32.36	$33.11	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $83.18 / $263.03	Professional		$53.70	$83.18	$263.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $54.95 / $199.53	Professional	26	$41.69	$54.95	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $24.55 / $63.10	Professional	TC	$13.49	$24.55	$63.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $89.13 / $89.13	Professional		$39.81	$89.13	$89.13
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $66.07 / $66.07	Professional	26	$29.51	$66.07	$66.07
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $10.23 / $22.91 / $22.91	Professional	TC	$10.23	$22.91	$22.91