Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.76 / $21.32 / $29.18	Facility	26	$20.76	$21.32	$29.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.79 / $121.05 / $174.09	Professional		$90.79	$121.05	$174.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.32 / $26.43 / $41.57	Professional	26	$21.32	$26.43	$41.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.65 / $97.12 / $141.03	Professional	TC	$61.65	$97.12	$141.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.75 / $27.46 / $60.28	Professional	26	$19.75	$27.46	$60.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.43 / $39.43 / $76.33	Facility	26	$39.43	$39.43	$76.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.84 / $214.41 / $388.63	Professional		$131.84	$214.41	$388.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.27 / $37.49 / $64.80	Professional	26	$23.27	$37.49	$64.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $119.17 / $188.09 / $332.31	Professional	TC	$119.17	$188.09	$332.31
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $28.06 / $28.06 / $28.06	Facility	26	$28.06	$28.06	$28.06
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $104.51 / $162.66 / $220.13	Professional		$104.51	$162.66	$220.13
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $21.05 / $30.52 / $41.19	Professional	26	$21.05	$30.52	$41.19
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $80.48 / $127.05 / $180.77	Professional	TC	$80.48	$127.05	$180.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.67 / $130.87 / $231.31	Professional		$36.67	$130.87	$231.31
United Facility/Professional Professional Modifier Low / Median / High Price $126.46 / $195.17 / $333.85	Professional		$126.46	$195.17	$333.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.66 / $32.84 / $55.55	Professional	26	$21.66	$32.84	$55.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $105.14 / $166.92 / $287.62	Professional	TC	$105.14	$166.92	$287.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $123.32 / $123.32 / $123.32	Professional		$123.32	$123.32	$123.32
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.06 / $27.06 / $27.06	Professional	26	$27.06	$27.06	$27.06
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $96.26 / $96.26 / $106.71	Professional	TC	$96.26	$96.26	$106.71