Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $152.41 / $152.41 / $152.41	Facility	26	$152.41	$152.41	$152.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.78 / $100.30 / $153.16	Professional		$73.78	$100.30	$153.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.72 / $37.32 / $133.62	Professional	26	$33.72	$37.32	$133.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.49 / $65.84 / $108.24	Professional	TC	$49.49	$65.84	$108.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $132.16 / $132.16 / $132.16	Professional		$132.16	$132.16	$132.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $19.78 / $48.18	Professional	26	$13.00	$19.78	$48.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.75 / $106.50 / $221.15	Professional		$59.75	$106.50	$221.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.65 / $41.19 / $85.98	Professional	26	$21.65	$41.19	$85.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.22 / $65.98 / $133.91	Professional	TC	$38.22	$65.98	$133.91
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $95.94 / $135.71 / $171.32	Professional		$95.94	$135.71	$171.32
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $40.02 / $54.73 / $63.69	Professional	26	$40.02	$54.73	$63.69
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $64.43 / $81.58 / $166.07	Professional	TC	$64.43	$81.58	$166.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.53 / $86.37 / $167.82	Professional		$41.53	$86.37	$167.82
United Facility/Professional Professional Modifier Low / Median / High Price $58.66 / $92.27 / $330.00	Professional		$58.66	$92.27	$330.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.69 / $34.56 / $128.09	Professional	26	$22.69	$34.56	$128.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.54 / $57.49 / $165.28	Professional	TC	$37.54	$57.49	$165.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $88.59 / $88.59	Professional		$39.86	$88.59	$88.59
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $31.91 / $31.91	Professional	26	$14.36	$31.91	$31.91
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.51 / $56.68 / $56.68	Professional	TC	$25.51	$56.68	$56.68