Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.02 / $96.02 / $96.02	Facility	26	$96.02	$96.02	$96.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.92 / $92.88 / $210.00	Professional		$60.92	$92.88	$210.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.35 / $28.27 / $89.55	Professional	26	$22.35	$28.27	$89.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.44 / $51.49 / $111.19	Professional	TC	$35.44	$51.49	$111.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.31 / $89.87 / $164.45	Professional		$72.31	$89.87	$164.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.61 / $40.03 / $54.47	Professional	26	$16.61	$40.03	$54.47
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $93.82 / $93.82 / $93.82	Professional	TC	$93.82	$93.82	$93.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.28 / $86.74 / $175.31	Professional		$48.28	$86.74	$175.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.75 / $30.83 / $61.76	Professional	26	$17.75	$30.83	$61.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.25 / $58.64 / $123.66	Professional	TC	$30.25	$58.64	$123.66
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $71.18 / $99.74 / $179.34	Professional		$71.18	$99.74	$179.34
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $30.14 / $40.06 / $53.14	Professional	26	$30.14	$40.06	$53.14
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $28.57 / $50.32 / $121.00	Professional	TC	$28.57	$50.32	$121.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $125.77 / $209.74	Professional		$41.40	$125.77	$209.74
United Facility/Professional Professional Modifier Low / Median / High Price $55.83 / $73.98 / $256.95	Professional		$55.83	$73.98	$256.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $25.39 / $103.63	Professional	26	$18.45	$25.39	$103.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.60 / $51.72 / $137.49	Professional	TC	$29.60	$51.72	$137.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $45.34 / $100.76 / $100.76	Professional		$45.34	$100.76	$100.76
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.89 / $24.20 / $24.20	Professional	26	$10.89	$24.20	$24.20
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $34.45 / $76.56 / $76.56	Professional	TC	$34.45	$76.56	$76.56