Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.80 / $20.45 / $22.58	Facility	26	$17.80	$20.45	$22.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.96 / $129.94 / $246.87	Professional		$102.96	$129.94	$246.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.60 / $22.58 / $37.59	Professional	26	$18.60	$22.58	$37.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.80 / $110.84 / $181.77	Professional	TC	$81.80	$110.84	$181.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.41 / $91.25 / $91.25	Professional		$84.41	$91.25	$91.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $30.78 / $40.83	Professional	26	$16.89	$30.78	$40.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.06 / $75.18	Facility	26	$27.06	$27.06	$75.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.52 / $172.62 / $310.54	Professional		$108.52	$172.62	$310.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.57 / $31.37 / $57.39	Professional	26	$20.57	$31.37	$57.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.42 / $147.78 / $265.88	Professional	TC	$91.42	$147.78	$265.88
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $27.85 / $27.85 / $27.85	Facility	26	$27.85	$27.85	$27.85
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $79.84 / $133.74 / $189.67	Professional		$79.84	$133.74	$189.67
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $15.96 / $24.60 / $36.20	Professional	26	$15.96	$24.60	$36.20
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $63.88 / $107.63 / $150.68	Professional	TC	$63.88	$107.63	$150.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $119.88 / $195.19	Professional		$36.17	$119.88	$195.19
United Facility/Professional Professional Modifier Low / Median / High Price $101.50 / $158.58 / $272.86	Professional		$101.50	$158.58	$272.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.12 / $26.31 / $49.08	Professional	26	$18.12	$26.31	$49.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.15 / $131.03 / $215.05	Professional	TC	$83.15	$131.03	$215.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.96 / $93.96 / $93.96	Professional		$93.96	$93.96	$93.96
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $17.62 / $17.62 / $17.62	Professional	26	$17.62	$17.62	$17.62
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $76.34 / $76.34 / $97.02	Professional	TC	$76.34	$76.34	$97.02