Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.34 / $35.72 / $40.32	Facility	26	$35.34	$35.72	$40.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.29 / $142.03 / $239.65	Professional		$108.29	$142.03	$239.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.72 / $45.29 / $69.34	Professional	26	$35.72	$45.29	$69.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.95 / $96.26 / $161.80	Professional	TC	$72.95	$96.26	$161.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.53 / $100.62 / $166.96	Professional		$85.53	$100.62	$166.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.97 / $40.34 / $61.83	Professional	26	$32.97	$40.34	$61.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.06 / $49.06 / $129.79	Facility	26	$49.06	$49.06	$129.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.55 / $189.22 / $321.32	Professional		$106.55	$189.22	$321.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.71 / $62.26 / $109.78	Professional	26	$40.71	$62.26	$109.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.87 / $134.63 / $231.84	Professional	TC	$83.87	$134.63	$231.84
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $47.00 / $47.00 / $47.00	Facility	26	$47.00	$47.00	$47.00
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $88.05 / $150.94 / $216.39	Professional		$88.05	$150.94	$216.39
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $28.85 / $49.46 / $64.36	Professional	26	$28.85	$49.46	$64.36
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $59.20 / $101.48 / $157.11	Professional	TC	$59.20	$101.48	$157.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.21 / $120.37 / $195.19	Professional		$39.21	$120.37	$195.19
United Facility/Professional Professional Modifier Low / Median / High Price $108.29 / $169.90 / $290.11	Professional		$108.29	$169.90	$290.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.84 / $52.65 / $89.06	Professional	26	$35.84	$52.65	$89.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.58 / $115.13 / $199.85	Professional	TC	$70.58	$115.13	$199.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $103.41 / $103.41 / $103.41	Professional		$103.41	$103.41	$103.41
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $32.68 / $32.68 / $32.68	Professional	26	$32.68	$32.68	$32.68
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $70.73 / $70.73 / $89.92	Professional	TC	$70.73	$70.73	$89.92