Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.48 / $65.38 / $71.16	Facility	26	$63.48	$65.38	$71.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.54 / $142.85 / $222.98	Professional		$118.54	$142.85	$222.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.89 / $80.29 / $127.13	Professional	26	$65.89	$80.29	$127.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.07 / $61.75 / $91.47	Professional	TC	$52.07	$61.75	$91.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.92 / $168.26 / $218.30	Professional		$115.92	$168.26	$218.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.00 / $100.31 / $134.29	Professional	26	$76.00	$100.31	$134.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.73 / $88.73 / $88.73	Facility	26	$88.73	$88.73	$88.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.90 / $174.25 / $301.81	Professional		$102.90	$174.25	$301.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.92 / $106.91 / $188.97	Professional	26	$67.92	$106.91	$188.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.58 / $82.02 / $149.36	Professional	TC	$48.58	$82.02	$149.36
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $64.77 / $103.80 / $158.99	Professional		$64.77	$103.80	$158.99
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $35.29 / $59.44 / $88.37	Professional	26	$35.29	$59.44	$88.37
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $29.49 / $44.23 / $69.20	Professional	TC	$29.49	$44.23	$69.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.01 / $110.91 / $185.17	Professional		$62.01	$110.91	$185.17
United Facility/Professional Professional Modifier Low / Median / High Price $110.53 / $156.16 / $269.38	Professional		$110.53	$156.16	$269.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.10 / $89.21 / $158.65	Professional	26	$62.10	$89.21	$158.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.59 / $69.53 / $118.77	Professional	TC	$48.59	$69.53	$118.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $101.36 / $101.36 / $119.38	Professional		$101.36	$101.36	$119.38
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $59.23 / $59.23 / $68.83	Professional	26	$59.23	$59.23	$68.83
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $42.13 / $42.13 / $53.51	Professional	TC	$42.13	$42.13	$53.51