Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.40 / $33.81 / $37.95	Facility	26	$33.40	$33.81	$37.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.14 / $73.42 / $133.94	Professional		$52.14	$73.42	$133.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.81 / $43.11 / $80.34	Professional	26	$33.81	$43.11	$80.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.35 / $27.45 / $49.13	Professional	TC	$16.35	$27.45	$49.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.62 / $75.48 / $120.93	Professional		$68.62	$75.48	$120.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.22 / $49.84 / $64.59	Professional	26	$36.22	$49.84	$64.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.26 / $46.26 / $46.26	Facility	26	$46.26	$46.26	$46.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.67 / $95.62 / $185.43	Professional		$66.67	$95.62	$185.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.44 / $58.11 / $114.40	Professional	26	$37.44	$58.11	$114.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.09 / $38.53 / $73.87	Professional	TC	$25.09	$38.53	$73.87
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $51.65 / $56.79 / $88.11	Professional		$51.65	$56.79	$88.11
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $27.27 / $29.21 / $49.44	Professional	26	$27.27	$29.21	$49.44
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $18.38 / $24.53 / $41.59	Professional	TC	$18.38	$24.53	$41.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.11 / $50.25 / $93.12	Professional		$29.11	$50.25	$93.12
United Facility/Professional Professional Modifier Low / Median / High Price $50.62 / $73.31 / $135.63	Professional		$50.62	$73.31	$135.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.40 / $45.97 / $81.20	Professional	26	$32.40	$45.97	$81.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.88 / $27.17 / $51.92	Professional	TC	$16.88	$27.17	$51.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $60.00 / $60.00	Professional		$60.00	$60.00	$60.00
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $30.89 / $30.89 / $30.89	Professional	26	$30.89	$30.89	$30.89
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $29.11 / $29.11 / $37.04	Professional	TC	$29.11	$29.11	$37.04