Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $169.82 / $169.82 / $169.82	Facility	26	$169.82	$169.82	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $79.43 / $181.97	Professional		$57.54	$79.43	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $60.26 / $229.09	Professional	26	$40.74	$60.26	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $26.92 / $61.66	Professional	TC	$16.98	$26.92	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $30.90 / $93.33	Professional	26	$12.88	$30.90	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $75.86 / $144.54	Professional		$44.67	$75.86	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $52.48 / $100.00	Professional	26	$30.20	$52.48	$100.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $22.91 / $44.67	Professional	TC	$13.49	$22.91	$44.67
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $100.00 / $169.82	Professional		$67.61	$100.00	$169.82
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $69.18 / $112.20	Professional	26	$43.65	$69.18	$112.20
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.84 / $57.54	Professional	TC	$21.88	$28.84	$57.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $93.33	Professional		$32.36	$33.11	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $57.54 / $218.78	Professional		$41.69	$57.54	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $39.81 / $151.36	Professional	26	$29.51	$39.81	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $19.95 / $61.66	Professional	TC	$13.18	$19.95	$61.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $69.18 / $69.18	Professional		$31.62	$69.18	$69.18
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $45.71 / $45.71	Professional	26	$20.42	$45.71	$45.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $23.99 / $23.99	Professional	TC	$10.72	$23.99	$23.99