Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.22 / $13.22 / $15.20	Facility	26	$13.22	$13.22	$15.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.83 / $59.89 / $126.22	Professional		$47.83	$59.89	$126.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.22 / $17.77 / $34.78	Professional	26	$13.22	$17.77	$34.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.61 / $39.94 / $84.50	Professional	TC	$34.61	$39.94	$84.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.29 / $98.41 / $115.21	Professional		$70.29	$98.41	$115.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.93 / $33.51	Professional	26	$19.95	$26.93	$33.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $50.34 / $50.34 / $74.91	Professional	TC	$50.34	$50.34	$74.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.32 / $23.32 / $23.32	Facility	26	$23.32	$23.32	$23.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $67.55 / $67.55	Professional		$67.55	$67.55	$67.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $18.45 / $18.45	Professional	26	$18.45	$18.45	$18.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $49.10 / $49.10	Professional	TC	$49.10	$49.10	$49.10
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $49.20 / $52.72 / $88.52	Professional		$49.20	$52.72	$88.52
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $13.96 / $14.96 / $24.01	Professional	26	$13.96	$14.96	$24.01
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $35.24 / $37.75 / $64.51	Professional	TC	$35.24	$37.75	$64.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.46 / $70.94 / $101.65	Professional		$50.46	$70.94	$101.65
United Facility/Professional Professional Modifier Low / Median / High Price $58.77 / $96.23 / $174.00	Professional		$58.77	$96.23	$174.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.01 / $20.59 / $36.96	Professional	26	$16.01	$20.59	$36.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.19 / $69.51 / $139.19	Professional	TC	$42.19	$69.51	$139.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.67 / $62.67 / $62.67	Professional		$62.67	$62.67	$62.67
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $17.11 / $17.11 / $17.11	Professional	26	$17.11	$17.11	$17.11
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $45.55 / $45.55 / $45.55	Professional	TC	$45.55	$45.55	$45.55