Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $165.02 / $165.02 / $165.02	Facility	26	$165.02	$165.02	$165.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.19 / $64.84 / $107.29	Professional		$57.19	$64.84	$107.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.07 / $51.10 / $107.23	Professional	26	$38.07	$51.10	$107.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $22.91 / $36.22	Professional	TC	$17.38	$22.91	$36.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.65 / $41.65 / $104.34	Professional		$41.65	$41.65	$104.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $68.81 / $107.97	Professional	26	$13.00	$68.81	$107.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.44 / $77.05 / $145.77	Professional		$45.44	$77.05	$145.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.10 / $53.37 / $98.96	Professional	26	$30.10	$53.37	$98.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.93 / $22.96 / $44.36	Professional	TC	$14.93	$22.96	$44.36
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $66.93 / $92.25 / $128.77	Professional		$66.93	$92.25	$128.77
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $44.02 / $68.18 / $85.64	Professional	26	$44.02	$68.18	$85.64
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $21.91 / $28.65 / $43.13	Professional	TC	$21.91	$28.65	$43.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.59 / $72.53 / $123.48	Professional		$32.59	$72.53	$123.48
United Facility/Professional Professional Modifier Low / Median / High Price $41.94 / $57.73 / $224.70	Professional		$41.94	$57.73	$224.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.72 / $39.07 / $154.69	Professional	26	$29.72	$39.07	$154.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.77 / $20.03 / $75.48	Professional	TC	$12.77	$20.03	$75.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.36 / $69.69 / $69.69	Professional		$31.36	$69.69	$69.69
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $20.56 / $45.69 / $45.69	Professional	26	$20.56	$45.69	$45.69
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $10.80 / $24.00 / $24.00	Professional	TC	$10.80	$24.00	$24.00