Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.92 / $32.04 / $35.38	Facility	26	$19.92	$32.04	$35.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.72 / $195.96 / $343.46	Professional		$159.72	$195.96	$343.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.35 / $35.38 / $67.18	Professional	26	$21.35	$35.38	$67.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.10 / $162.49 / $252.87	Professional	TC	$125.10	$162.49	$252.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $127.97 / $154.61 / $411.35	Professional		$127.97	$154.61	$411.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.20 / $41.32 / $79.69	Professional	26	$27.20	$41.32	$79.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.28 / $43.28 / $117.78	Facility	26	$43.28	$43.28	$117.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.60 / $268.57 / $470.79	Professional		$168.60	$268.57	$470.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.08 / $44.73 / $87.77	Professional	26	$27.08	$44.73	$87.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.40 / $234.77 / $410.40	Professional	TC	$144.40	$234.77	$410.40
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $43.28 / $43.28 / $43.28	Facility	26	$43.28	$43.28	$43.28
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $127.98 / $204.24 / $289.52	Professional		$127.98	$204.24	$289.52
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $21.61 / $36.79 / $54.64	Professional	26	$21.61	$36.79	$54.64
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $102.21 / $173.34 / $244.41	Professional	TC	$102.21	$173.34	$244.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.08 / $191.71 / $305.14	Professional		$38.08	$191.71	$305.14
United Facility/Professional Professional Modifier Low / Median / High Price $164.99 / $244.86 / $418.02	Professional		$164.99	$244.86	$418.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.03 / $39.00 / $80.50	Professional	26	$21.03	$39.00	$80.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $136.38 / $203.77 / $338.30	Professional	TC	$136.38	$203.77	$338.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $150.63 / $150.63 / $150.63	Professional		$150.63	$150.63	$150.63
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 $122.04 / $122.04 / $155.31	Professional	TC	$122.04	$122.04	$155.31