Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.30 / $71.92 / $209.63	Facility	26	$51.30	$71.92	$209.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $225.20 / $391.18	Professional		$171.00	$225.20	$391.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $60.97 / $90.99	Professional	26	$51.30	$60.97	$90.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $152.90 / $300.27	Professional	TC	$119.70	$152.90	$300.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.14 / $121.87 / $147.99	Professional		$73.14	$121.87	$147.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.06 / $61.62 / $104.19	Professional	26	$33.06	$61.62	$104.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $184.61	Facility	26	$68.70	$68.70	$184.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.63 / $270.41 / $546.19	Professional		$137.63	$270.41	$546.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.79 / $70.84 / $128.13	Professional	26	$42.79	$70.84	$128.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.99 / $189.51 / $421.53	Professional	TC	$93.99	$189.51	$421.53
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $67.20 / $67.20 / $67.20	Facility	26	$67.20	$67.20	$67.20
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $154.12 / $241.81 / $365.52	Professional		$154.12	$241.81	$365.52
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $47.05 / $71.66 / $89.98	Professional	26	$47.05	$71.66	$89.98
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $104.84 / $165.36 / $285.86	Professional	TC	$104.84	$165.36	$285.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $146.59 / $243.86	Professional		$41.40	$146.59	$243.86
United Facility/Professional Professional Modifier Low / Median / High Price $159.38 / $239.09 / $474.88	Professional		$159.38	$239.09	$474.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.14 / $58.05 / $111.63	Professional	26	$49.14	$58.05	$111.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.47 / $170.45 / $344.48	Professional	TC	$107.47	$170.45	$344.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $132.99 / $132.99 / $132.99	Professional		$132.99	$132.99	$132.99
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $41.75 / $41.75 / $41.75	Professional	26	$41.75	$41.75	$41.75
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $91.24 / $91.24 / $91.24	Professional	TC	$91.24	$91.24	$91.24