Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $15.85 / $27.54	Facility	26	$14.13	$15.85	$27.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $75.86 / $295.12	Professional		$52.48	$75.86	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $22.91 / $97.72	Professional	26	$15.85	$22.91	$97.72
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.84 / $104.71 / $263.03	Professional	50	$28.84	$104.71	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $44.67 / $79.43	Professional	TC	$33.11	$44.67	$79.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $61.66 / $102.33	Professional		$53.70	$61.66	$102.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $23.99 / $33.11	Professional	26	$16.60	$23.99	$33.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.37 / $20.42 / $29.51	Facility	26	$4.37	$20.42	$29.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $77.62 / $138.04	Professional		$53.70	$77.62	$138.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $24.55 / $43.65	Professional	26	$15.85	$24.55	$43.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $53.70 / $100.00	Professional	TC	$38.02	$53.70	$100.00
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $46.77 / $75.86	Professional		$23.44	$46.77	$75.86
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $14.45 / $23.99	Professional	26	$7.24	$14.45	$23.99
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $33.88 / $52.48	Professional	TC	$16.22	$33.88	$52.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $36.31 / $93.33	Professional		$18.62	$36.31	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $64.57 / $120.23	Professional		$46.77	$64.57	$120.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $19.95 / $37.15	Professional	26	$14.45	$19.95	$37.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $44.67 / $81.28	Professional	TC	$31.62	$44.67	$81.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $67.61	Professional		$45.71	$45.71	$67.61
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $13.80 / $18.62	Professional	26	$13.80	$13.80	$18.62
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $31.62 / $48.98	Professional	TC	$31.62	$31.62	$48.98