Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.23 / $120.23 / $120.23	Facility	26	$120.23	$120.23	$120.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $239.88 / $416.87	Professional		$162.18	$239.88	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $38.90 / $104.71	Professional	26	$28.84	$38.90	$104.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $208.93 / $446.68	Professional	TC	$128.82	$208.93	$446.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $173.78 / $302.00	Professional		$128.82	$173.78	$302.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $19.50 / $44.67	Professional	26	$12.88	$19.50	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $213.80 / $467.74	Professional		$104.71	$213.80	$467.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $36.31 / $70.79	Professional	26	$21.38	$36.31	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $173.78 / $407.38	Professional	TC	$83.18	$173.78	$407.38
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $229.09 / $346.74	Professional		$147.91	$229.09	$346.74
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $46.77 / $75.86	Professional	26	$31.62	$46.77	$75.86
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $173.78 / $302.00	Professional	TC	$114.82	$173.78	$302.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $316.23	Professional		$32.36	$33.11	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $208.93 / $691.83	Professional		$117.49	$208.93	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $28.18 / $109.65	Professional	26	$20.89	$28.18	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $173.78 / $602.56	Professional	TC	$93.33	$173.78	$602.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $208.93 / $208.93	Professional		$93.33	$208.93	$208.93
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $30.90 / $30.90	Professional	26	$13.80	$30.90	$30.90
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $177.83 / $177.83	Professional	TC	$79.43	$177.83	$177.83