Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.44 / $32.29 / $56.61	Facility	26	$31.44	$32.29	$56.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.93 / $167.69 / $361.35	Professional		$119.93	$167.69	$361.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.58 / $51.67 / $125.43	Professional	26	$33.58	$51.67	$125.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.64 / $116.38 / $247.75	Professional	TC	$87.64	$116.38	$247.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.84 / $136.47 / $307.89	Professional		$98.84	$136.47	$307.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.76 / $34.59 / $80.45	Professional	26	$27.76	$34.59	$80.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $83.43 / $83.43 / $83.43	Professional	TC	$83.43	$83.43	$83.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.24 / $43.24 / $115.54	Facility	26	$43.24	$43.24	$115.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.57 / $225.02 / $396.05	Professional		$138.57	$225.02	$396.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.40 / $60.10 / $109.62	Professional	26	$35.40	$60.10	$109.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $110.18 / $172.80 / $300.66	Professional	TC	$110.18	$172.80	$300.66
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $42.49 / $42.49 / $42.49	Facility	26	$42.49	$42.49	$42.49
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $102.60 / $177.03 / $239.33	Professional		$102.60	$177.03	$239.33
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $26.29 / $48.02 / $65.73	Professional	26	$26.29	$48.02	$65.73
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $77.19 / $126.16 / $174.80	Professional	TC	$77.19	$126.16	$174.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.08 / $130.87 / $231.31	Professional		$38.08	$130.87	$231.31
United Facility/Professional Professional Modifier Low / Median / High Price $133.97 / $204.61 / $345.17	Professional		$133.97	$204.61	$345.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.70 / $53.64 / $92.68	Professional	26	$33.70	$53.64	$92.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.90 / $149.00 / $251.10	Professional	TC	$100.90	$149.00	$251.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $120.77 / $120.77 / $120.77	Professional		$120.77	$120.77	$120.77
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 $92.17 / $92.17 / $106.96	Professional	TC	$92.17	$92.17	$106.96