Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $36.31 / $38.90	Facility	26	$34.67	$36.31	$38.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $158.49 / $338.84	Professional		$114.82	$158.49	$338.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $52.48 / $123.03	Professional	26	$38.02	$52.48	$123.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $107.15 / $223.87	Professional	TC	$77.62	$107.15	$223.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $107.15 / $165.96	Professional		$87.10	$107.15	$165.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $57.54 / $75.86	Professional	26	$33.11	$57.54	$75.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $48.98 / $83.18	Facility	26	$10.47	$48.98	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $186.21 / $338.84	Professional		$104.71	$186.21	$338.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $60.26 / $112.20	Professional	26	$41.69	$60.26	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $134.90 / $251.19	Professional	TC	$85.11	$134.90	$251.19
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $46.77 / $46.77	Facility	26	$46.77	$46.77	$46.77
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $128.82 / $218.78	Professional		$93.33	$128.82	$218.78
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $43.65 / $66.07	Professional	26	$30.20	$43.65	$66.07
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $87.10 / $158.49	Professional	TC	$63.10	$87.10	$158.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $70.79 / $151.36	Professional		$32.36	$70.79	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $165.96 / $281.84	Professional		$107.15	$165.96	$281.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $50.12 / $87.10	Professional	26	$35.48	$50.12	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $112.20 / $199.53	Professional	TC	$70.79	$112.20	$199.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $134.90	Professional		$102.33	$102.33	$134.90
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $32.36 / $42.66	Professional	26	$32.36	$32.36	$42.66
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $70.79 / $91.20	Professional	TC	$70.79	$70.79	$91.20