Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $36.31 / $38.90	Facility	26	$34.67	$36.31	$38.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $87.10 / $134.90	Professional		$69.18	$87.10	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $44.67 / $83.18	Professional	26	$36.31	$44.67	$83.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $40.74 / $60.26	Professional	TC	$30.90	$40.74	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $81.28 / $95.50	Professional		$74.13	$81.28	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $41.69 / $45.71	Professional	26	$40.74	$41.69	$45.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $50.12 / $70.79	Facility	26	$10.72	$50.12	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $104.71 / $194.98	Professional		$69.18	$104.71	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $58.88 / $107.15	Professional	26	$39.81	$58.88	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $50.12 / $95.50	Professional	TC	$30.90	$50.12	$95.50
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $66.07 / $112.20	Professional		$40.74	$66.07	$112.20
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $35.48 / $57.54	Professional	26	$23.99	$35.48	$57.54
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $33.11 / $53.70	Professional	TC	$14.45	$33.11	$53.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $35.48 / $102.33	Professional		$32.36	$35.48	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $87.10 / $162.18	Professional		$61.66	$87.10	$162.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $47.86 / $91.20	Professional	26	$34.67	$47.86	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $38.90 / $75.86	Professional	TC	$25.70	$38.90	$75.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $66.07 / $93.33	Professional		$66.07	$66.07	$93.33
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $33.11 / $44.67	Professional	26	$33.11	$33.11	$44.67
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $33.11 / $48.98	Professional	TC	$33.11	$33.11	$48.98