Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.72 / $19.70 / $21.75	Facility	26	$13.72	$19.70	$21.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.72 / $123.07 / $220.82	Professional		$91.72	$123.07	$220.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.40 / $22.06 / $49.45	Professional	26	$14.40	$22.06	$49.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.54 / $102.26 / $160.85	Professional	TC	$79.54	$102.26	$160.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.20 / $84.96 / $195.93	Professional		$72.20	$84.96	$195.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.68 / $30.15 / $48.79	Professional	26	$16.68	$30.15	$48.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.70 / $26.70 / $72.37	Facility	26	$26.70	$26.70	$72.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.92 / $171.36 / $308.50	Professional		$107.92	$171.36	$308.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.34 / $27.81 / $54.01	Professional	26	$17.34	$27.81	$54.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.51 / $148.05 / $271.47	Professional	TC	$92.51	$148.05	$271.47
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $26.59 / $26.59 / $26.59	Facility	26	$26.59	$26.59	$26.59
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $79.29 / $130.11 / $187.57	Professional		$79.29	$130.11	$187.57
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $14.41 / $22.60 / $33.57	Professional	26	$14.41	$22.60	$33.57
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $63.66 / $111.22 / $151.19	Professional	TC	$63.66	$111.22	$151.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $119.65 / $195.19	Professional		$36.17	$119.65	$195.19
United Facility/Professional Professional Modifier Low / Median / High Price $102.38 / $155.25 / $269.38	Professional		$102.38	$155.25	$269.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.00 / $24.42 / $50.18	Professional	26	$14.00	$24.42	$50.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.89 / $131.27 / $222.93	Professional	TC	$84.89	$131.27	$222.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.45 / $93.45 / $93.45	Professional		$93.45	$93.45	$93.45
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $17.36 / $17.36 / $17.36	Professional	26	$17.36	$17.36	$17.36
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $76.09 / $76.09 / $96.70	Professional	TC	$76.09	$76.09	$96.70