Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.17 / $10.28 / $13.33	Facility	26	$10.17	$10.28	$13.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.56 / $93.77 / $176.45	Professional		$70.56	$93.77	$176.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.29 / $12.84 / $26.14	Professional	26	$10.29	$12.84	$26.14
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $35.28 / $40.75 / $57.79	Professional	52	$35.28	$40.75	$57.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.07 / $81.41 / $140.08	Professional	TC	$60.07	$81.41	$140.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.57 / $64.28 / $114.43	Professional		$51.57	$64.28	$114.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.29 / $20.76	Professional	26	$8.51	$11.29	$20.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.54 / $13.54 / $37.38	Facility	26	$13.54	$13.54	$37.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.58 / $115.33 / $201.81	Professional		$70.58	$115.33	$201.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.01 / $16.67 / $29.36	Professional	26	$11.01	$16.67	$29.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.88 / $103.93 / $177.94	Professional	TC	$63.88	$103.93	$177.94
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $13.79 / $13.79 / $13.79	Facility	26	$13.79	$13.79	$13.79
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $53.08 / $83.56 / $127.33	Professional		$53.08	$83.56	$127.33
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $13.97 / $18.10	Professional	26	$8.15	$13.97	$18.10
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $44.94 / $71.14 / $107.76	Professional	TC	$44.94	$71.14	$107.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.64 / $72.97 / $119.59	Professional		$48.64	$72.97	$119.59
United Facility/Professional Professional Modifier Low / Median / High Price $68.84 / $106.25 / $179.92	Professional		$68.84	$106.25	$179.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.84 / $13.80 / $25.33	Professional	26	$9.84	$13.80	$25.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.64 / $91.44 / $158.75	Professional	TC	$58.64	$91.44	$158.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.55 / $62.55 / $62.55	Professional		$62.55	$62.55	$62.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.94 / $8.94 / $8.94	Professional	26	$8.94	$8.94	$8.94
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $53.61 / $53.61 / $68.29	Professional	TC	$53.61	$53.61	$68.29