Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.06 / $65.34 / $72.13	Facility	26	$65.06	$65.34	$72.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $157.44 / $219.15	Professional		$130.08	$157.44	$219.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.64 / $80.54 / $111.17	Professional	26	$66.64	$80.54	$111.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.79 / $79.09 / $107.98	Professional	TC	$54.79	$79.09	$107.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $245.64 / $245.64 / $245.64	Professional		$245.64	$245.64	$245.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.38 / $91.83 / $137.37	Professional	26	$66.38	$91.83	$137.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.04 / $91.04 / $91.04	Facility	26	$91.04	$91.04	$91.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.90 / $180.86 / $338.37	Professional		$102.90	$180.86	$338.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.20 / $107.36 / $193.63	Professional	26	$68.20	$107.36	$193.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.08 / $99.67 / $183.48	Professional	TC	$50.08	$99.67	$183.48
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $55.55 / $108.83 / $155.47	Professional		$55.55	$108.83	$155.47
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $36.19 / $60.86 / $96.40	Professional	26	$36.19	$60.86	$96.40
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $19.36 / $48.01 / $75.44	Professional	TC	$19.36	$48.01	$75.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.97 / $116.36 / $212.48	Professional		$62.97	$116.36	$212.48
United Facility/Professional Professional Modifier Low / Median / High Price $111.01 / $168.44 / $312.44	Professional		$111.01	$168.44	$312.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.72 / $89.12 / $165.84	Professional	26	$63.72	$89.12	$165.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.17 / $82.83 / $168.25	Professional	TC	$39.17	$82.83	$168.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $117.96 / $117.96 / $137.66	Professional		$117.96	$117.96	$137.66
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $60.51 / $60.51 / $69.56	Professional	26	$60.51	$60.51	$69.56
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $57.45 / $57.45 / $72.88	Professional	TC	$57.45	$57.45	$72.88