Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $22.39 / $30.20	Facility	26	$19.95	$22.39	$30.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $158.49 / $416.87	Professional		$91.20	$158.49	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $39.81 / $104.71	Professional	26	$22.91	$39.81	$104.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $89.13 / $186.21	Professional	TC	$66.07	$89.13	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $95.50 / $169.82	Professional		$72.44	$95.50	$169.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $30.20 / $45.71	Professional	26	$19.50	$30.20	$45.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $47.86	Facility	26	$6.03	$28.18	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $131.83 / $229.09	Professional		$85.11	$131.83	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $34.67 / $63.10	Professional	26	$23.99	$34.67	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $104.71 / $186.21	Professional	TC	$70.79	$104.71	$186.21
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $26.92 / $26.92	Facility	26	$26.92	$26.92	$26.92
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $109.65 / $162.18	Professional		$69.18	$109.65	$162.18
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $23.99 / $37.15	Professional	26	$17.38	$23.99	$37.15
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $79.43 / $128.82	Professional	TC	$51.29	$79.43	$128.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $56.23 / $109.65	Professional		$21.88	$56.23	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $114.82 / $194.98	Professional		$81.28	$114.82	$194.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $28.84 / $48.98	Professional	26	$20.42	$28.84	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $87.10 / $144.54	Professional	TC	$60.26	$87.10	$144.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $97.72	Professional		$74.13	$74.13	$97.72
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $18.62 / $24.55	Professional	26	$18.62	$18.62	$24.55
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $56.23 / $74.13	Professional	TC	$56.23	$56.23	$74.13