Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $67.61 / $144.54	Professional		$47.86	$67.61	$144.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $26.92 / $79.43	Professional	26	$19.05	$26.92	$79.43
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $50.12 / $50.12 / $50.12	Professional	52	$50.12	$50.12	$50.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $33.88 / $60.26	Professional	TC	$25.70	$33.88	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $60.26 / $100.00	Professional		$52.48	$60.26	$100.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $38.02 / $44.67	Professional	26	$26.30	$38.02	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $67.61 / $114.82	Professional		$45.71	$67.61	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $28.18 / $47.86	Professional	26	$19.05	$28.18	$47.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $39.81 / $64.57	Professional	TC	$25.70	$39.81	$64.57
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $57.54 / $72.44	Professional		$38.90	$57.54	$72.44
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $23.99 / $30.20	Professional	26	$13.49	$23.99	$30.20
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $34.67 / $41.69	Professional	TC	$25.12	$34.67	$41.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $64.57	Professional		$32.36	$33.11	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $57.54 / $87.10	Professional		$42.66	$57.54	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $22.91 / $34.67	Professional	26	$17.78	$22.91	$34.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $33.88 / $53.70	Professional	TC	$23.99	$33.88	$53.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $60.26	Professional		$47.86	$47.86	$60.26
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $19.95 / $19.95	Professional	26	$19.95	$19.95	$19.95
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $28.18 / $28.18	Professional	TC	$28.18	$28.18	$28.18