Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.27 / $102.27 / $102.27	Facility	26	$102.27	$102.27	$102.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.47 / $108.10 / $144.97	Professional		$72.47	$108.10	$144.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $33.79 / $55.47	Professional	26	$25.70	$33.79	$55.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $74.12 / $98.98	Professional	TC	$46.77	$74.12	$98.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.09 / $64.09 / $64.38	Professional	26	$64.09	$64.09	$64.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.43 / $117.39 / $237.75	Professional		$64.43	$117.39	$237.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.63 / $37.67 / $88.83	Professional	26	$20.63	$37.67	$88.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.93 / $82.50 / $152.90	Professional	TC	$41.93	$82.50	$152.90
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $138.13 / $176.83 / $379.34	Professional		$138.13	$176.83	$379.34
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $39.28 / $58.92 / $87.71	Professional	26	$39.28	$58.92	$87.71
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $98.86 / $118.04 / $148.28	Professional	TC	$98.86	$118.04	$148.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.53 / $125.08 / $209.74	Professional		$41.53	$125.08	$209.74
United Facility/Professional Professional Modifier Low / Median / High Price $61.32 / $108.32 / $353.29	Professional		$61.32	$108.32	$353.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.64 / $36.97 / $119.29	Professional	26	$19.64	$36.97	$119.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.28 / $72.45 / $206.42	Professional	TC	$41.28	$72.45	$206.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.35 / $114.12 / $114.12	Professional		$51.35	$114.12	$114.12
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $31.40 / $31.40	Professional	26	$14.13	$31.40	$31.40
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $37.22 / $82.72 / $82.72	Professional	TC	$37.22	$82.72	$82.72