Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.33 / $36.97 / $40.10	Facility	26	$36.33	$36.97	$40.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.39 / $131.60 / $184.00	Professional		$107.39	$131.60	$184.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.65 / $44.16 / $57.59	Professional	26	$37.65	$44.16	$57.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.18 / $84.56 / $126.68	Professional	TC	$67.18	$84.56	$126.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.47 / $109.93 / $187.80	Professional		$96.47	$109.93	$187.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.22 / $43.22 / $43.22	Professional	26	$43.22	$43.22	$43.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.38 / $50.38 / $50.38	Facility	26	$50.38	$50.38	$50.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.93 / $170.09 / $337.62	Professional		$101.93	$170.09	$337.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.86 / $60.18 / $109.87	Professional	26	$37.86	$60.18	$109.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.77 / $109.38 / $234.10	Professional	TC	$66.77	$109.38	$234.10
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $55.73 / $92.21 / $143.43	Professional		$55.73	$92.21	$143.43
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $20.99 / $33.81 / $53.22	Professional	26	$20.99	$33.81	$53.22
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $36.04 / $54.14 / $88.46	Professional	TC	$36.04	$54.14	$88.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $89.76 / $172.54	Professional		$37.20	$89.76	$172.54
United Facility/Professional Professional Modifier Low / Median / High Price $97.19 / $139.69 / $265.39	Professional		$97.19	$139.69	$265.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.54 / $48.77 / $92.41	Professional	26	$34.54	$48.77	$92.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.78 / $90.66 / $197.33	Professional	TC	$59.78	$90.66	$197.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.45 / $97.45 / $109.93	Professional		$97.45	$97.45	$109.93
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $36.15 / $36.15 / $40.82	Professional	26	$36.15	$36.15	$40.82
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $61.29 / $61.29 / $67.67	Professional	TC	$61.29	$61.29	$67.67