Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.53 / $27.34 / $96.67	Facility	26	$17.53	$27.34	$96.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.34 / $91.12 / $137.83	Professional		$61.34	$91.12	$137.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.53 / $25.52 / $100.30	Professional	26	$17.53	$25.52	$100.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.81 / $63.93 / $93.78	Professional	TC	$43.81	$63.93	$93.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $59.68 / $175.68	Professional		$57.66	$59.68	$175.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $37.72 / $51.35	Professional	26	$13.00	$37.72	$51.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.49 / $99.81 / $204.31	Professional		$48.49	$99.81	$204.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.83 / $27.05 / $56.06	Professional	26	$13.83	$27.05	$56.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.82 / $73.80 / $160.07	Professional	TC	$34.82	$73.80	$160.07
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $80.69 / $89.53 / $157.47	Professional		$80.69	$89.53	$157.47
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $21.93 / $23.49 / $41.33	Professional	26	$21.93	$23.49	$41.33
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $57.63 / $66.03 / $115.25	Professional	TC	$57.63	$66.03	$115.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $123.74 / $177.04	Professional		$40.43	$123.74	$177.04
United Facility/Professional Professional Modifier Low / Median / High Price $54.34 / $80.70 / $256.77	Professional		$54.34	$80.70	$256.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.76 / $21.40 / $72.18	Professional	26	$14.76	$21.40	$72.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.85 / $59.30 / $198.17	Professional	TC	$38.85	$59.30	$198.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $91.38 / $91.38 / $91.38	Professional		$91.38	$91.38	$91.38
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.14 / $23.14 / $23.14	Professional	26	$23.14	$23.14	$23.14
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $68.23 / $68.23 / $68.23	Professional	TC	$68.23	$68.23	$68.23