Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $55.17 / $213.15	Facility	26	$51.29	$55.17	$213.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $240.35 / $447.42	Professional		$171.00	$240.35	$447.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $67.88 / $187.67	Professional	26	$51.30	$67.88	$187.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $154.04 / $272.25	Professional	TC	$119.70	$154.04	$272.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.13 / $139.44 / $256.02	Professional		$111.13	$139.44	$256.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.85 / $71.29 / $134.10	Professional	26	$47.85	$71.29	$134.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $87.57 / $87.57 / $87.57	Professional	TC	$87.57	$87.57	$87.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.84 / $74.84 / $201.09	Facility	26	$74.84	$74.84	$201.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.80 / $254.08 / $493.89	Professional		$137.80	$254.08	$493.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.52 / $72.00 / $136.91	Professional	26	$46.52	$72.00	$136.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.96 / $176.78 / $359.85	Professional	TC	$89.96	$176.78	$359.85
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $73.62 / $73.62 / $73.62	Facility	26	$73.62	$73.62	$73.62
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $168.44 / $260.32 / $341.48	Professional		$168.44	$260.32	$341.48
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $51.53 / $76.38 / $96.62	Professional	26	$51.53	$76.38	$96.62
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $117.82 / $184.23 / $248.50	Professional	TC	$117.82	$184.23	$248.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $133.63 / $230.95	Professional		$62.75	$133.63	$230.95
United Facility/Professional Professional Modifier Low / Median / High Price $158.74 / $223.33 / $411.42	Professional		$158.74	$223.33	$411.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.17 / $58.12 / $120.19	Professional	26	$51.17	$58.12	$120.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.28 / $157.26 / $296.83	Professional	TC	$102.28	$157.26	$296.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $121.48 / $121.48 / $121.48	Professional		$121.48	$121.48	$121.48
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $41.57 / $41.57 / $41.57	Professional	26	$41.57	$41.57	$41.57
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $79.92 / $79.92 / $79.92	Professional	TC	$79.92	$79.92	$79.92