Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.19 / $20.43 / $25.12	Facility	26	$20.19	$20.43	$25.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.69 / $110.69 / $271.14	Professional		$83.69	$110.69	$271.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.43 / $28.45 / $108.73	Professional	26	$20.43	$28.45	$108.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.42 / $80.09 / $137.19	Professional	TC	$60.42	$80.09	$137.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.40 / $122.18 / $166.99	Professional		$72.40	$122.18	$166.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.79 / $31.82 / $70.70	Professional	26	$19.79	$31.82	$70.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.20 / $28.20 / $74.15	Facility	26	$28.20	$28.20	$74.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.41 / $135.37 / $224.41	Professional		$83.41	$135.37	$224.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.37 / $35.44 / $61.72	Professional	26	$23.37	$35.44	$61.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.28 / $104.87 / $178.95	Professional	TC	$67.28	$104.87	$178.95
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $26.88 / $26.88 / $26.88	Facility	26	$26.88	$26.88	$26.88
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $63.35 / $113.88 / $163.80	Professional		$63.35	$113.88	$163.80
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $16.50 / $28.22 / $36.88	Professional	26	$16.50	$28.22	$36.88
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $46.85 / $86.76 / $129.87	Professional	TC	$46.85	$86.76	$129.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.11 / $83.84 / $142.01	Professional		$36.11	$83.84	$142.01
United Facility/Professional Professional Modifier Low / Median / High Price $81.66 / $118.15 / $195.67	Professional		$81.66	$118.15	$195.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $30.08 / $50.16	Professional	26	$20.50	$30.08	$50.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.80 / $86.51 / $149.66	Professional	TC	$57.80	$86.51	$149.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $74.55 / $74.55 / $74.55	Professional		$74.55	$74.55	$74.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $18.64 / $18.64 / $18.64	Professional	26	$18.64	$18.64	$18.64
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $55.91 / $55.91 / $71.20	Professional	TC	$55.91	$55.91	$71.20