Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.11 / $89.11 / $89.11	Facility	26	$89.11	$89.11	$89.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.73 / $96.48 / $221.79	Professional		$66.73	$96.48	$221.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.26 / $27.61 / $63.00	Professional	26	$21.26	$27.61	$63.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.47 / $65.55 / $167.60	Professional	TC	$45.47	$65.55	$167.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $124.32 / $124.32 / $124.32	Professional		$124.32	$124.32	$124.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.00 / $37.00 / $37.00	Professional	26	$37.00	$37.00	$37.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.91 / $111.39 / $271.05	Professional		$54.91	$111.39	$271.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.57 / $32.97 / $78.48	Professional	26	$16.57	$32.97	$78.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.64 / $77.44 / $183.58	Professional	TC	$37.64	$77.44	$183.58
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $101.35 / $171.78 / $231.82	Professional		$101.35	$171.78	$231.82
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $30.78 / $46.17 / $80.98	Professional	26	$30.78	$46.17	$80.98
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $70.58 / $126.71 / $312.05	Professional	TC	$70.58	$126.71	$312.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $86.37 / $167.82	Professional		$41.40	$86.37	$167.82
United Facility/Professional Professional Modifier Low / Median / High Price $52.31 / $103.62 / $319.86	Professional		$52.31	$103.62	$319.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.23 / $29.16 / $88.45	Professional	26	$16.23	$29.16	$88.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.07 / $69.30 / $188.20	Professional	TC	$36.07	$69.30	$188.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $37.57 / $83.48 / $83.48	Professional		$37.57	$83.48	$83.48
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.03 / $24.51 / $24.51	Professional	26	$11.03	$24.51	$24.51
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $26.54 / $58.97 / $58.97	Professional	TC	$26.54	$58.97	$58.97