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 / $180.70	Facility	26	$51.29	$58.95	$180.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.16 / $194.37 / $357.00	Professional		$154.16	$194.37	$357.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $56.89 / $137.66	Professional	26	$51.30	$56.89	$137.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.80 / $125.10 / $270.13	Professional	TC	$100.80	$125.10	$270.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.73 / $108.12 / $324.36	Professional		$80.73	$108.12	$324.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.20 / $61.67 / $112.73	Professional	26	$39.20	$61.67	$112.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.98 / $60.98 / $163.13	Facility	26	$60.98	$60.98	$163.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.70 / $225.30 / $483.68	Professional		$107.70	$225.30	$483.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.01 / $64.23 / $121.28	Professional	26	$38.01	$64.23	$121.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $160.27 / $347.50	Professional	TC	$74.13	$160.27	$347.50
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $59.73 / $59.73 / $59.73	Facility	26	$59.73	$59.73	$59.73
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $126.38 / $198.28 / $301.77	Professional		$126.38	$198.28	$301.77
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $41.81 / $64.20 / $80.14	Professional	26	$41.81	$64.20	$80.14
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $83.08 / $133.21 / $228.71	Professional	TC	$83.08	$133.21	$228.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.60 / $115.05 / $192.18	Professional		$40.60	$115.05	$192.18
United Facility/Professional Professional Modifier Low / Median / High Price $130.91 / $201.28 / $384.12	Professional		$130.91	$201.28	$384.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.32 / $52.77 / $106.40	Professional	26	$44.32	$52.77	$106.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.80 / $137.27 / $269.38	Professional	TC	$84.80	$137.27	$269.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.04 / $109.04 / $109.04	Professional		$109.04	$109.04	$109.04
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $36.81 / $36.81 / $36.81	Professional	26	$36.81	$36.81	$36.81
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $72.23 / $72.23 / $72.23	Professional	TC	$72.23	$72.23	$72.23