Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.67 / $48.67 / $54.30	Facility	26	$48.67	$48.67	$54.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.08 / $129.25 / $239.43	Professional		$97.08	$129.25	$239.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.02 / $59.91 / $96.07	Professional	26	$49.02	$59.91	$96.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.40 / $63.49 / $142.32	Professional	TC	$48.40	$63.49	$142.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.76 / $97.17 / $160.05	Professional		$87.76	$97.17	$160.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.32 / $46.32 / $46.32	Professional	26	$46.32	$46.32	$46.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.87 / $67.87 / $178.77	Facility	26	$67.87	$67.87	$178.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.94 / $179.54 / $323.10	Professional		$107.94	$179.54	$323.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.79 / $81.06 / $139.53	Professional	26	$52.79	$81.06	$139.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.38 / $91.55 / $184.26	Professional	TC	$52.38	$91.55	$184.26
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $64.50 / $64.50 / $64.50	Facility	26	$64.50	$64.50	$64.50
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $76.79 / $142.66 / $222.01	Professional		$76.79	$142.66	$222.01
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $39.64 / $67.72 / $86.35	Professional	26	$39.64	$67.72	$86.35
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $40.79 / $72.92 / $141.05	Professional	TC	$40.79	$72.92	$141.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.36 / $83.95 / $144.23	Professional		$41.36	$83.95	$144.23
United Facility/Professional Professional Modifier Low / Median / High Price $101.46 / $162.38 / $271.26	Professional		$101.46	$162.38	$271.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.25 / $68.22 / $120.22	Professional	26	$47.25	$68.22	$120.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.35 / $87.90 / $159.58	Professional	TC	$49.35	$87.90	$159.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.36 / $89.36 / $89.36	Professional		$89.36	$89.36	$89.36
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $44.94 / $44.94 / $44.94	Professional	26	$44.94	$44.94	$44.94
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $44.42 / $44.42 / $56.42	Professional	TC	$44.42	$44.42	$56.42