Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $58.95 / $186.18	Facility	26	$51.29	$58.95	$186.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $233.80 / $400.99	Professional		$171.00	$233.80	$400.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $59.50 / $116.74	Professional	26	$51.30	$59.50	$116.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $162.81 / $310.67	Professional	TC	$119.70	$162.81	$310.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.00 / $127.73 / $383.20	Professional		$109.00	$127.73	$383.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $69.52 / $109.52	Professional	26	$39.97	$69.52	$109.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.34 / $61.34 / $201.09	Facility	26	$61.34	$61.34	$201.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.75 / $281.00 / $548.01	Professional		$134.75	$281.00	$548.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.01 / $69.59 / $126.19	Professional	26	$38.01	$69.59	$126.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $101.33 / $211.95 / $426.10	Professional	TC	$101.33	$211.95	$426.10
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $73.26 / $73.26 / $73.26	Facility	26	$73.26	$73.26	$73.26
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $170.31 / $291.89 / $392.63	Professional		$170.31	$291.89	$392.63
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $50.37 / $73.26 / $96.16	Professional	26	$50.37	$73.26	$96.16
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $130.51 / $217.82 / $296.89	Professional	TC	$130.51	$217.82	$296.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.60 / $146.16 / $243.86	Professional		$40.60	$146.16	$243.86
United Facility/Professional Professional Modifier Low / Median / High Price $174.34 / $250.61 / $454.00	Professional		$174.34	$250.61	$454.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.12 / $56.92 / $108.15	Professional	26	$46.12	$56.92	$108.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.22 / $192.33 / $346.91	Professional	TC	$128.22	$192.33	$346.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $139.81 / $139.81 / $139.81	Professional		$139.81	$139.81	$139.81
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $39.97 / $39.97	Professional	26	$39.97	$39.97	$39.97
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $99.83 / $99.83 / $99.83	Professional	TC	$99.83	$99.83	$99.83