Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.83 / $31.94 / $43.31	Facility	26	$25.83	$31.94	$43.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.40 / $203.83 / $498.26	Professional		$155.40	$203.83	$498.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.91 / $39.31 / $99.00	Professional	26	$28.91	$39.31	$99.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.08 / $161.94 / $273.83	Professional	TC	$124.08	$161.94	$273.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.64 / $147.04 / $313.93	Professional		$117.64	$147.04	$313.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.57 / $35.72 / $67.67	Professional	26	$27.57	$35.72	$67.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $109.87 / $112.07 / $151.76	Professional	TC	$109.87	$112.07	$151.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.27 / $43.27 / $117.37	Facility	26	$43.27	$43.27	$117.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.35 / $264.16 / $469.57	Professional		$165.35	$264.16	$469.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.07 / $47.44 / $87.86	Professional	26	$31.07	$47.44	$87.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $139.86 / $228.06 / $397.50	Professional	TC	$139.86	$228.06	$397.50
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $43.02 / $43.02 / $43.02	Facility	26	$43.02	$43.02	$43.02
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $121.78 / $198.50 / $284.00	Professional		$121.78	$198.50	$284.00
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $25.64 / $37.71 / $56.47	Professional	26	$25.64	$37.71	$56.47
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $96.14 / $164.80 / $234.08	Professional	TC	$96.14	$164.80	$234.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.08 / $166.70 / $286.20	Professional		$38.08	$166.70	$286.20
United Facility/Professional Professional Modifier Low / Median / High Price $159.27 / $238.02 / $402.41	Professional		$159.27	$238.02	$402.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.54 / $40.78 / $76.17	Professional	26	$26.54	$40.78	$76.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.03 / $198.12 / $341.19	Professional	TC	$128.03	$198.12	$341.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $143.49 / $143.49 / $143.49	Professional		$143.49	$143.49	$143.49
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $28.60 / $28.60 / $28.60	Professional	26	$28.60	$28.60	$28.60
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $114.89 / $114.89 / $146.02	Professional	TC	$114.89	$114.89	$146.02