Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $394.00 / $3,261.00 / $11,550.00	Facility		$394.00	$3,261.00	$11,550.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.60 / $107.13 / $116.10	Facility	26	$104.60	$107.13	$116.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.98 / $370.30 / $744.02	Professional		$255.98	$370.30	$744.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.13 / $124.31 / $215.71	Professional	26	$107.13	$124.31	$215.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.85 / $237.40 / $365.43	Professional	TC	$148.85	$237.40	$365.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $337.49 / $337.49 / $497.36	Professional		$337.49	$337.49	$497.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $222.57 / $226.15 / $323.00	Facility		$222.57	$226.15	$323.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $315.88 / $454.59 / $719.70	Professional		$315.88	$454.59	$719.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.63 / $172.98 / $265.24	Professional	26	$106.63	$172.98	$265.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $201.34 / $287.33 / $453.48	Professional	TC	$201.34	$287.33	$453.48
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $2,104.00 / $3,151.00 / $7,224.00	Facility		$2,104.00	$3,151.00	$7,224.00
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $228.85 / $252.99 / $444.99	Professional		$228.85	$252.99	$444.99
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $86.14 / $92.29 / $162.34	Professional	26	$86.14	$92.29	$162.34
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $133.04 / $160.69 / $282.66	Professional	TC	$133.04	$160.69	$282.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $258.66 / $461.54	Professional		$131.90	$258.66	$461.54
United Facility/Professional Facility Modifier Low / Median / High Price $539.00 / $2,671.00 / $5,507.00	Facility		$539.00	$2,671.00	$5,507.00
United Facility/Professional Professional Modifier Low / Median / High Price $280.17 / $423.59 / $737.90	Professional		$280.17	$423.59	$737.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.47 / $158.36 / $255.27	Professional	26	$108.47	$158.36	$255.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.47 / $256.43 / $479.32	Professional	TC	$173.47	$256.43	$479.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $274.73 / $274.73 / $274.73	Professional		$274.73	$274.73	$274.73
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $95.24 / $95.24 / $127.57	Professional	26	$95.24	$95.24	$127.57
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $179.49 / $179.49 / $227.69	Professional	TC	$179.49	$179.49	$227.69