Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $30.20 / $32.36	Facility	26	$28.84	$30.20	$32.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $77.62 / $173.78	Professional		$56.23	$77.62	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $45.71 / $102.33	Professional	26	$33.88	$45.71	$102.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $35.48 / $64.57	Professional	TC	$16.98	$35.48	$64.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $69.18 / $117.49	Professional		$63.10	$69.18	$117.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $40.74 / $57.54	Professional	26	$33.11	$40.74	$57.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $40.74 / $57.54	Facility	26	$8.71	$40.74	$57.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $91.20 / $181.97	Professional		$61.66	$91.20	$181.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $54.95 / $109.65	Professional	26	$33.88	$54.95	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $37.15 / $74.13	Professional	TC	$23.99	$37.15	$74.13
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $52.48 / $77.62	Professional		$28.84	$52.48	$77.62
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.30 / $40.74	Professional	26	$19.95	$26.30	$40.74
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $8.71 / $23.99 / $38.02	Professional	TC	$8.71	$23.99	$38.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $44.67 / $104.71	Professional		$32.36	$44.67	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $67.61 / $123.03	Professional		$47.86	$67.61	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $43.65 / $75.86	Professional	26	$30.20	$43.65	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $25.70 / $47.86	Professional	TC	$15.85	$25.70	$47.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $53.70 / $53.70	Professional		$26.92	$53.70	$53.70
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $35.48 / $35.48	Professional	26	$35.48	$35.48	$35.48
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $34.67 / $34.67	Professional	TC	$34.67	$34.67	$34.67