Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $71.37 / $208.53	Facility	26	$51.29	$71.37	$208.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $256.85 / $412.52	Professional		$171.00	$256.85	$412.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $60.93 / $90.99	Professional	26	$51.30	$60.93	$90.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $184.55 / $306.26	Professional	TC	$119.70	$184.55	$306.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.68 / $166.69 / $445.77	Professional		$138.68	$166.69	$445.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.06 / $94.43 / $122.66	Professional	26	$33.06	$94.43	$122.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $210.13	Facility	26	$68.70	$68.70	$210.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.22 / $317.39 / $628.91	Professional		$157.22	$317.39	$628.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.57 / $74.14 / $136.00	Professional	26	$42.57	$74.14	$136.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.16 / $239.27 / $489.00	Professional	TC	$115.16	$239.27	$489.00
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $76.50 / $76.50 / $76.50	Facility	26	$76.50	$76.50	$76.50
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $198.12 / $332.18 / $435.74	Professional		$198.12	$332.18	$435.74
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $52.59 / $76.50 / $100.40	Professional	26	$52.59	$76.50	$100.40
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $140.51 / $253.85 / $331.22	Professional	TC	$140.51	$253.85	$331.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $179.68 / $296.03	Professional		$41.40	$179.68	$296.03
United Facility/Professional Professional Modifier Low / Median / High Price $193.39 / $286.50 / $551.33	Professional		$193.39	$286.50	$551.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.65 / $59.49 / $118.14	Professional	26	$51.65	$59.49	$118.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.74 / $219.51 / $403.20	Professional	TC	$141.74	$219.51	$403.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $163.19 / $163.19	Professional		$163.19	$163.19	$163.19
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $44.76 / $44.76 / $44.76	Professional	26	$44.76	$44.76	$44.76
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $118.44 / $118.44 / $118.44	Professional	TC	$118.44	$118.44	$118.44