Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $616.60 / $616.60	Facility		$616.60	$616.60	$616.60
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $104.71 / $104.71	Facility	26	$104.71	$104.71	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $144.54 / $467.74	Professional		$104.71	$144.54	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $66.07 / $389.05	Professional	26	$28.18	$66.07	$389.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $100.00 / $234.42	Professional	TC	$63.10	$100.00	$234.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $104.71 / $234.42	Professional		$79.43	$104.71	$234.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $35.48 / $58.88	Professional	26	$14.13	$35.48	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $117.49 / $251.19	Professional		$58.88	$117.49	$251.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $31.62 / $63.10	Professional	26	$19.05	$31.62	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $83.18 / $194.98	Professional	TC	$39.81	$83.18	$194.98
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $128.82 / $229.09	Professional		$83.18	$128.82	$229.09
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $42.66 / $67.61	Professional	26	$28.18	$42.66	$67.61
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $85.11 / $181.97	Professional	TC	$54.95	$85.11	$181.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $165.96	Professional		$32.36	$33.11	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $56.23 / $141.25	Facility		$15.14	$56.23	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $104.71 / $354.81	Professional		$67.61	$104.71	$354.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $25.12 / $95.50	Professional	26	$18.20	$25.12	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $79.43 / $269.15	Professional	TC	$44.67	$79.43	$269.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $109.65 / $109.65	Professional		$48.98	$109.65	$109.65
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $23.99 / $23.99	Professional	26	$10.72	$23.99	$23.99
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $85.11 / $85.11	Professional	TC	$38.90	$85.11	$85.11