Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.20 / $114.54 / $157.58	Professional		$81.20	$114.54	$157.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.85 / $14.87 / $19.20	Professional	26	$11.85	$14.87	$19.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.45 / $97.79 / $132.91	Professional	TC	$69.45	$97.79	$132.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $110.78 / $117.67 / $210.63	Professional		$110.78	$117.67	$210.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.77 / $26.77 / $26.77	Professional	26	$26.77	$26.77	$26.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.84 / $121.84 / $183.86	Professional		$82.84	$121.84	$183.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.39 / $16.94 / $26.73	Professional	26	$11.39	$16.94	$26.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.91 / $107.59 / $163.05	Professional	TC	$71.91	$107.59	$163.05
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $32.79 / $95.42 / $133.09	Professional		$32.79	$95.42	$133.09
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $5.87 / $12.04 / $17.01	Professional	26	$5.87	$12.04	$17.01
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $91.58 / $128.21	Professional	TC	$26.92	$91.58	$128.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $113.71 / $148.24 / $194.11	Professional		$113.71	$148.24	$194.11
United Facility/Professional Professional Modifier Low / Median / High Price $63.53 / $88.51 / $159.15	Professional		$63.53	$88.51	$159.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.13 / $13.00 / $24.28	Professional	26	$10.13	$13.00	$24.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.41 / $77.87 / $145.01	Professional	TC	$52.41	$77.87	$145.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $101.11 / $101.11 / $101.11	Professional		$101.11	$101.11	$101.11
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $11.23 / $11.23	Professional	26	$11.23	$11.23	$11.23
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $89.88 / $89.88 / $114.13	Professional	TC	$89.88	$89.88	$114.13