Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.13 / $30.51 / $34.97	Facility	26	$30.13	$30.51	$34.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.69 / $72.47 / $142.22	Professional		$49.69	$72.47	$142.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.51 / $38.81 / $74.40	Professional	26	$30.51	$38.81	$74.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.44 / $28.89 / $52.67	Professional	TC	$16.44	$28.89	$52.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $67.47 / $72.38 / $121.50	Professional		$67.47	$72.38	$121.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.25 / $46.80 / $57.13	Professional	26	$32.25	$46.80	$57.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.65 / $41.65 / $41.65	Facility	26	$41.65	$41.65	$41.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.16 / $90.61 / $175.87	Professional		$64.16	$90.61	$175.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.97 / $52.47 / $102.53	Professional	26	$32.97	$52.47	$102.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.76 / $41.07 / $78.23	Professional	TC	$24.76	$41.07	$78.23
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $50.78 / $53.23 / $86.63	Professional		$50.78	$53.23	$86.63
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $24.27 / $26.01 / $45.05	Professional	26	$24.27	$26.01	$45.05
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $26.51 / $41.67	Professional	TC	$17.78	$26.51	$41.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.86 / $53.78 / $128.00	Professional		$28.86	$53.78	$128.00
United Facility/Professional Professional Modifier Low / Median / High Price $46.64 / $67.80 / $122.28	Professional		$46.64	$67.80	$122.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.81 / $41.52 / $75.47	Professional	26	$28.81	$41.52	$75.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.18 / $27.13 / $54.26	Professional	TC	$16.18	$27.13	$54.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $59.24 / $59.24 / $59.24	Professional		$59.24	$59.24	$59.24
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.58 / $27.58 / $27.58	Professional	26	$27.58	$27.58	$27.58
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $31.66 / $31.66 / $40.28	Professional	TC	$31.66	$31.66	$40.28