Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $50.12 / $53.70	Facility	26	$48.98	$50.12	$53.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $245.47	Professional		$85.11	$114.82	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $72.44 / $154.88	Professional	26	$54.95	$72.44	$154.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $44.67 / $85.11	Professional	TC	$22.91	$44.67	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $104.71 / $190.55	Professional		$93.33	$104.71	$190.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $75.86 / $97.72	Professional	26	$52.48	$75.86	$97.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $97.72	Facility	26	$14.45	$67.61	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $269.15	Professional		$91.20	$131.83	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $173.78	Professional	26	$54.95	$85.11	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $47.86 / $100.00	Professional	TC	$30.90	$47.86	$100.00
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $77.62 / $112.20	Professional		$40.74	$77.62	$112.20
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $43.65 / $67.61	Professional	26	$28.84	$43.65	$67.61
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $30.20 / $47.86	Professional	TC	$12.02	$30.20	$47.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $61.66 / $144.54	Professional		$32.36	$61.66	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $181.97	Professional		$70.79	$100.00	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $66.07 / $120.23	Professional	26	$47.86	$66.07	$120.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $33.11 / $60.26	Professional	TC	$21.38	$33.11	$60.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $102.33	Professional		$79.43	$79.43	$102.33
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $45.71 / $58.88	Professional	26	$45.71	$45.71	$58.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $33.88 / $43.65	Professional	TC	$33.88	$33.88	$43.65