Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.22 / $30.02 / $34.86	Facility	26	$29.22	$30.02	$34.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.80 / $123.30 / $184.65	Professional		$79.80	$123.30	$184.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.22 / $41.39 / $56.25	Professional	26	$29.22	$41.39	$56.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $79.79 / $122.30	Professional	TC	$46.77	$79.79	$122.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $248.21 / $248.21 / $248.21	Professional		$248.21	$248.21	$248.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.33 / $65.33 / $65.33	Professional	26	$65.33	$65.33	$65.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.14 / $47.14 / $124.57	Facility	26	$47.14	$47.14	$124.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.51 / $145.38 / $249.45	Professional		$92.51	$145.38	$249.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.06 / $54.10 / $87.29	Professional	26	$34.06	$54.10	$87.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.42 / $94.16 / $160.05	Professional	TC	$60.42	$94.16	$160.05
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $67.14 / $108.98 / $174.37	Professional		$67.14	$108.98	$174.37
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $24.52 / $38.69 / $53.62	Professional	26	$24.52	$38.69	$53.62
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $42.61 / $73.04 / $126.81	Professional	TC	$42.61	$73.04	$126.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.19 / $124.09 / $226.32	Professional		$37.19	$124.09	$226.32
United Facility/Professional Professional Modifier Low / Median / High Price $81.45 / $122.18 / $210.72	Professional		$81.45	$122.18	$210.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.72 / $47.79 / $83.01	Professional	26	$33.72	$47.79	$83.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.79 / $73.18 / $134.72	Professional	TC	$46.79	$73.18	$134.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $25.29 / $25.29	Professional	26	$25.29	$25.29	$25.29
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $70.20 / $70.20 / $112.27	Professional	TC	$70.20	$70.20	$112.27