Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.04 / $67.04 / $73.25	Facility		$67.04	$67.04	$73.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $164.16 / $164.16 / $164.16	Facility	26	$164.16	$164.16	$164.16
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $75.20 / $75.20 / $80.18	Facility	TC	$75.20	$75.20	$80.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.24 / $79.40 / $170.78	Professional		$55.24	$79.40	$170.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.78 / $75.98 / $755.41	Professional	26	$38.78	$75.98	$755.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.93 / $25.75 / $48.70	Professional	TC	$18.93	$25.75	$48.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.88 / $46.22 / $70.98	Professional		$45.88	$46.22	$70.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $55.94 / $94.05	Professional	26	$13.00	$55.94	$94.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.83 / $28.83 / $34.79	Professional	TC	$28.83	$28.83	$34.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.84 / $78.17 / $147.56	Professional		$48.84	$78.17	$147.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.05 / $54.60 / $99.62	Professional	26	$30.05	$54.60	$99.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.64 / $25.64 / $49.44	Professional	TC	$16.64	$25.64	$49.44
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $63.93 / $92.60 / $141.97	Professional		$63.93	$92.60	$141.97
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $42.85 / $68.52 / $86.07	Professional	26	$42.85	$68.52	$86.07
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $14.89 / $26.75 / $53.50	Professional	TC	$14.89	$26.75	$53.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.94 / $73.02 / $123.49	Professional		$32.94	$73.02	$123.49
United Facility/Professional Professional Modifier Low / Median / High Price $45.70 / $60.20 / $228.63	Professional		$45.70	$60.20	$228.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.72 / $38.65 / $154.66	Professional	26	$29.72	$38.65	$154.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.98 / $20.20 / $70.02	Professional	TC	$15.98	$20.20	$70.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $34.70 / $77.09 / $77.09	Professional		$34.70	$77.09	$77.09
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $20.68 / $45.95 / $45.95	Professional	26	$20.68	$45.95	$45.95
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.02 / $31.15 / $31.15	Professional	TC	$14.02	$31.15	$31.15