Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.31 / $79.31 / $79.31	Facility	26	$79.31	$79.31	$79.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.62 / $75.42 / $105.24	Professional		$46.62	$75.42	$105.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.19 / $22.18 / $36.00	Professional	26	$16.19	$22.18	$36.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.43 / $51.92 / $77.18	Professional	TC	$30.43	$51.92	$77.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $148.94 / $148.94 / $148.94	Professional		$148.94	$148.94	$148.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.84 / $51.84 / $51.84	Professional	26	$51.84	$51.84	$51.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.29 / $77.34 / $164.83	Professional		$37.29	$77.34	$164.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.91 / $25.03 / $48.94	Professional	26	$12.91	$25.03	$48.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.17 / $52.47 / $115.20	Professional	TC	$25.17	$52.47	$115.20
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $53.05 / $78.88 / $145.72	Professional		$53.05	$78.88	$145.72
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $26.55 / $42.60	Professional	26	$17.82	$26.55	$42.60
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $35.22 / $52.33 / $107.60	Professional	TC	$35.22	$52.33	$107.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.36 / $116.78 / $168.98	Professional		$41.36	$116.78	$168.98
United Facility/Professional Professional Modifier Low / Median / High Price $41.29 / $67.18 / $233.14	Professional		$41.29	$67.18	$233.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.30 / $20.18 / $68.80	Professional	26	$14.30	$20.18	$68.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.01 / $47.37 / $165.30	Professional	TC	$27.01	$47.37	$165.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.31 / $62.92 / $62.92	Professional		$28.31	$62.92	$62.92
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.15 / $15.89 / $15.89	Professional	26	$7.15	$15.89	$15.89
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $21.16 / $47.03 / $47.03	Professional	TC	$21.16	$47.03	$47.03