Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.61 / $29.88	Facility	26	$27.06	$27.61	$29.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.31 / $96.70 / $122.87	Professional		$64.31	$96.70	$122.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.14 / $34.31 / $47.11	Professional	26	$28.14	$34.31	$47.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.03 / $62.70 / $81.61	Professional	TC	$33.03	$62.70	$81.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.32 / $90.39 / $154.69	Professional		$85.32	$90.39	$154.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.89 / $36.53 / $50.10	Professional	26	$31.89	$36.53	$50.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.61 / $38.61 / $38.61	Facility	26	$38.61	$38.61	$38.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $108.10 / $202.28	Professional		$62.75	$108.10	$202.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.19 / $45.73 / $81.16	Professional	26	$29.19	$45.73	$81.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.47 / $68.34 / $136.57	Professional	TC	$29.47	$68.34	$136.57
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $27.04 / $66.06 / $102.33	Professional		$27.04	$66.06	$102.33
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $15.44 / $25.99 / $39.29	Professional	26	$15.44	$25.99	$39.29
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $11.33 / $43.33 / $61.70	Professional	TC	$11.33	$43.33	$61.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.60 / $83.14 / $140.09	Professional		$36.60	$83.14	$140.09
United Facility/Professional Professional Modifier Low / Median / High Price $54.50 / $87.78 / $165.15	Professional		$54.50	$87.78	$165.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.34 / $36.96 / $67.55	Professional	26	$26.34	$36.96	$67.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.48 / $51.79 / $106.34	Professional	TC	$20.48	$51.79	$106.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $83.92	Professional		$77.62	$77.62	$83.92
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $25.79 / $25.79 / $27.88	Professional	26	$25.79	$25.79	$27.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $51.83 / $51.83 / $65.78	Professional	TC	$51.83	$51.83	$65.78