Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.81 / $104.98 / $142.68	Professional		$80.81	$104.98	$142.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.08 / $77.91 / $100.95	Professional	26	$63.08	$77.91	$100.95
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $50.98 / $50.98 / $291.14	Professional	52	$50.98	$50.98	$291.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $28.24 / $36.77	Professional	TC	$17.57	$28.24	$36.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.60 / $96.86 / $173.38	Professional		$95.60	$96.86	$173.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $136.68 / $136.68 / $136.68	Professional	26	$136.68	$136.68	$136.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.44 / $115.85 / $195.70	Professional		$79.44	$115.85	$195.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.01 / $89.84 / $145.62	Professional	26	$59.01	$89.84	$145.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.26 / $29.19 / $44.25	Professional	TC	$18.26	$29.19	$44.25
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $69.23 / $98.90 / $121.90	Professional		$69.23	$98.90	$121.90
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $30.69 / $61.64 / $87.12	Professional	26	$30.69	$61.64	$87.12
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $6.65 / $22.71 / $31.79	Professional	TC	$6.65	$22.71	$31.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.63 / $111.46 / $166.36	Professional		$34.63	$111.46	$166.36
United Facility/Professional Professional Modifier Low / Median / High Price $68.03 / $91.70 / $155.79	Professional		$68.03	$91.70	$155.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.09 / $69.42 / $119.01	Professional	26	$54.09	$69.42	$119.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.30 / $20.90 / $39.40	Professional	TC	$13.30	$20.90	$39.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $80.17 / $80.17 / $80.17	Professional		$80.17	$80.17	$80.17
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $57.96 / $57.96 / $57.96	Professional	26	$57.96	$57.96	$57.96
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.21 / $22.21 / $28.33	Professional	TC	$22.21	$22.21	$28.33