Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.46 / $50.13 / $57.28	Facility	26	$49.46	$50.13	$57.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.78 / $100.45 / $168.19	Professional		$71.78	$100.45	$168.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.13 / $62.96 / $105.92	Professional	26	$50.13	$62.96	$105.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.61 / $35.27 / $56.50	Professional	TC	$21.61	$35.27	$56.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.27 / $107.65 / $132.49	Professional		$91.27	$107.65	$132.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.22 / $73.18 / $108.30	Professional	26	$53.22	$73.18	$108.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.20 / $68.20 / $68.20	Facility	26	$68.20	$68.20	$68.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.00 / $129.24 / $252.68	Professional		$89.00	$129.24	$252.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.23 / $85.11 / $166.52	Professional	26	$54.23	$85.11	$166.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.14 / $46.70 / $91.94	Professional	TC	$31.14	$46.70	$91.94
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $68.70 / $76.54 / $117.19	Professional		$68.70	$76.54	$117.19
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $40.06 / $42.92 / $73.77	Professional	26	$40.06	$42.92	$73.77
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $23.78 / $30.46 / $48.86	Professional	TC	$23.78	$30.46	$48.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.59 / $59.62 / $135.46	Professional		$29.59	$59.62	$135.46
United Facility/Professional Professional Modifier Low / Median / High Price $70.25 / $100.05 / $183.71	Professional		$70.25	$100.05	$183.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.93 / $68.59 / $123.96	Professional	26	$46.93	$68.59	$123.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.51 / $32.96 / $63.34	Professional	TC	$21.51	$32.96	$63.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.66 / $79.66 / $79.66	Professional		$79.66	$79.66	$79.66
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $45.45 / $45.45 / $45.45	Professional	26	$45.45	$45.45	$45.45
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $34.21 / $34.21 / $43.51	Professional	TC	$34.21	$34.21	$43.51