Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $27.54 / $102.33	Facility	26	$17.38	$27.54	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $245.47	Professional		$81.28	$107.15	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $36.31 / $169.82	Professional	26	$21.88	$36.31	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $79.43 / $162.18	Professional	TC	$58.88	$79.43	$162.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $64.57 / $173.78	Professional		$57.54	$64.57	$173.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $23.44 / $51.29	Professional	26	$14.13	$23.44	$51.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $44.67	Professional	TC	$44.67	$44.67	$44.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $63.10 / $102.33	Facility	26	$15.14	$63.10	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $81.28 / $194.98	Professional		$48.98	$81.28	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $21.38 / $53.70	Professional	26	$13.80	$21.38	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $61.66 / $144.54	Professional	TC	$35.48	$61.66	$144.54
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $91.20 / $154.88	Professional		$85.11	$91.20	$154.88
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $22.91 / $39.81	Professional	26	$21.88	$22.91	$39.81
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $67.61 / $114.82	Professional	TC	$63.10	$67.61	$114.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $134.90	Professional		$32.36	$33.11	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $81.28 / $251.19	Professional		$54.95	$81.28	$251.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $21.38 / $66.07	Professional	26	$15.49	$21.38	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $58.88 / $181.97	Professional	TC	$38.90	$58.88	$181.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $91.20 / $91.20	Professional		$40.74	$91.20	$91.20
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $22.91 / $22.91	Professional	26	$10.47	$22.91	$22.91
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $67.61 / $67.61	Professional	TC	$30.90	$67.61	$67.61