Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.56 / $56.27 / $66.23	Facility	26	$36.56	$56.27	$66.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.47 / $145.86 / $226.81	Professional		$87.47	$145.86	$226.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.16 / $56.27 / $99.35	Professional	26	$41.16	$56.27	$99.35
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $43.11 / $65.09 / $101.41	Professional	52	$43.11	$65.09	$101.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.55 / $87.87 / $148.60	Professional	TC	$45.55	$87.87	$148.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.91 / $90.44 / $104.00	Professional		$83.91	$90.44	$104.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.36 / $62.12 / $68.68	Professional	26	$42.36	$62.12	$68.68
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $20.35 / $20.98 / $25.93	Professional	52	$20.35	$20.98	$25.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.80 / $49.80 / $49.80	Facility	26	$49.80	$49.80	$49.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $191.89 / $328.82	Professional		$85.00	$191.89	$328.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.31 / $74.34 / $126.76	Professional	26	$39.31	$74.34	$126.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.21 / $115.86 / $200.48	Professional	TC	$44.21	$115.86	$200.48
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $63.16 / $81.20 / $205.31	Professional		$63.16	$81.20	$205.31
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $29.08 / $34.78 / $96.57	Professional	26	$29.08	$34.78	$96.57
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $34.08 / $43.82 / $99.52	Professional	TC	$34.08	$43.82	$99.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $79.18 / $135.67	Professional		$37.20	$79.18	$135.67
United Facility/Professional Professional Modifier Low / Median / High Price $92.10 / $163.47 / $299.89	Professional		$92.10	$163.47	$299.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.95 / $62.56 / $115.44	Professional	26	$36.95	$62.56	$115.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.30 / $99.50 / $187.21	Professional	TC	$55.30	$99.50	$187.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.51 / $79.51 / $94.28	Professional		$79.51	$79.51	$94.28
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $35.61 / $35.61 / $41.54	Professional	26	$35.61	$35.61	$41.54
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $43.89 / $43.89 / $48.69	Professional	TC	$43.89	$43.89	$48.69