Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.29 / $55.19 / $75.79	Facility	26	$54.29	$55.19	$75.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.88 / $160.32 / $232.49	Professional		$128.88	$160.32	$232.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.03 / $68.56 / $105.95	Professional	26	$58.03	$68.56	$105.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $133.15 / $144.51 / $197.53	Professional		$133.15	$144.51	$197.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.27 / $87.66 / $123.30	Professional	26	$47.27	$87.66	$123.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.80 / $76.80 / $199.36	Facility	26	$76.80	$76.80	$199.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.94 / $194.68 / $320.95	Professional		$134.94	$194.68	$320.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.04 / $86.41 / $135.77	Professional	26	$60.04	$86.41	$135.77
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $68.81 / $137.63 / $176.39	Professional		$68.81	$137.63	$176.39
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $30.80 / $63.06 / $83.20	Professional	26	$30.80	$63.06	$83.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.81 / $105.38 / $173.20	Professional		$61.81	$105.38	$173.20
United Facility/Professional Professional Modifier Low / Median / High Price $118.64 / $158.69 / $262.33	Professional		$118.64	$158.69	$262.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.54 / $69.88 / $112.65	Professional	26	$51.54	$69.88	$112.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $118.98 / $118.98 / $146.32	Professional		$118.98	$118.98	$146.32
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $51.06 / $51.06 / $64.93	Professional	26	$51.06	$51.06	$64.93