Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $70.01 / $281.45	Facility	26	$51.29	$70.01	$281.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $300.00 / $501.01	Professional		$171.00	$300.00	$501.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $84.82 / $249.45	Professional	26	$51.30	$84.82	$249.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $215.87 / $365.17	Professional	TC	$119.70	$215.87	$365.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.72 / $182.11 / $278.56	Professional		$158.72	$182.11	$278.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.32 / $95.47 / $170.13	Professional	26	$61.32	$95.47	$170.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $137.91 / $207.63 / $207.63	Professional	TC	$137.91	$207.63	$207.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.56 / $94.56 / $254.13	Facility	26	$94.56	$94.56	$254.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.17 / $390.07 / $800.46	Professional		$199.17	$390.07	$800.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.00 / $89.54 / $173.05	Professional	26	$59.00	$89.54	$173.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.56 / $274.06 / $655.95	Professional	TC	$145.56	$274.06	$655.95
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $92.92 / $92.92 / $92.92	Facility	26	$92.92	$92.92	$92.92
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $221.30 / $341.16 / $442.61	Professional		$221.30	$341.16	$442.61
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $65.04 / $96.40 / $121.96	Professional	26	$65.04	$96.40	$121.96
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $153.93 / $239.74 / $330.14	Professional	TC	$153.93	$239.74	$330.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $182.70 / $337.96	Professional		$95.09	$182.70	$337.96
United Facility/Professional Professional Modifier Low / Median / High Price $230.90 / $351.49 / $684.57	Professional		$230.90	$351.49	$684.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.48 / $75.06 / $152.69	Professional	26	$64.48	$75.06	$152.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.41 / $260.00 / $533.73	Professional	TC	$159.41	$260.00	$533.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $211.96 / $211.96 / $211.96	Professional		$211.96	$211.96	$211.96
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $61.17 / $61.17 / $61.17	Professional	26	$61.17	$61.17	$61.17
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $150.79 / $150.79 / $150.79	Professional	TC	$150.79	$150.79	$150.79