Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.43 / $40.28 / $72.53	Facility	26	$36.43	$40.28	$72.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.50 / $97.92 / $192.50	Professional		$73.50	$97.92	$192.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.15 / $46.66 / $101.74	Professional	26	$40.15	$46.66	$101.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $166.92 / $190.28 / $295.82	Professional	50	$166.92	$190.28	$295.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.09 / $50.74 / $71.73	Professional	TC	$35.09	$50.74	$71.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.20 / $94.02 / $153.04	Professional		$81.20	$94.02	$153.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.52 / $61.02 / $77.01	Professional	26	$42.52	$61.02	$77.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.51 / $50.51 / $50.51	Facility	26	$50.51	$50.51	$50.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.87 / $116.06 / $205.27	Professional		$80.87	$116.06	$205.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.61 / $61.83 / $115.38	Professional	26	$38.61	$61.83	$115.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.30 / $60.41 / $112.99	Professional	TC	$43.30	$60.41	$112.99
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $61.12 / $73.15 / $102.06	Professional		$61.12	$73.15	$102.06
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $29.83 / $35.89 / $54.03	Professional	26	$29.83	$35.89	$54.03
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $31.29 / $35.76 / $53.64	Professional	TC	$31.29	$35.76	$53.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.86 / $54.73 / $134.73	Professional		$28.86	$54.73	$134.73
United Facility/Professional Professional Modifier Low / Median / High Price $70.39 / $100.85 / $188.22	Professional		$70.39	$100.85	$188.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.34 / $52.01 / $89.10	Professional	26	$35.34	$52.01	$89.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.40 / $51.03 / $91.15	Professional	TC	$35.40	$51.03	$91.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $71.48 / $71.48 / $77.30	Professional		$71.48	$71.48	$77.30
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.96 / $33.96 / $36.72	Professional	26	$33.96	$33.96	$36.72
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $37.53 / $37.53 / $47.45	Professional	TC	$37.53	$37.53	$47.45