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 / $300.29 / $540.77	Professional		$171.00	$300.29	$540.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $84.82 / $287.73	Professional	26	$51.30	$84.82	$287.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $217.28 / $373.69	Professional	TC	$119.70	$217.28	$373.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.05 / $167.03 / $557.12	Professional		$91.05	$167.03	$557.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.32 / $91.98 / $170.13	Professional	26	$61.32	$91.98	$170.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $103.10 / $103.10 / $103.10	Professional	TC	$103.10	$103.10	$103.10
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 $195.50 / $416.11 / $846.33	Professional		$195.50	$416.11	$846.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.00 / $93.28 / $178.99	Professional	26	$59.00	$93.28	$178.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $140.27 / $302.57 / $673.89	Professional	TC	$140.27	$302.57	$673.89
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 $220.77 / $341.16 / $441.54	Professional		$220.77	$341.16	$441.54
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 $153.40 / $239.34 / $330.14	Professional	TC	$153.40	$239.34	$330.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $182.70 / $338.55	Professional		$95.09	$182.70	$338.55
United Facility/Professional Professional Modifier Low / Median / High Price $230.23 / $361.19 / $687.50	Professional		$230.23	$361.19	$687.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.97 / $75.50 / $158.91	Professional	26	$64.97	$75.50	$158.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.41 / $260.35 / $550.15	Professional	TC	$159.41	$260.35	$550.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $213.07 / $213.07 / $213.07	Professional		$213.07	$213.07	$213.07
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $61.56 / $61.56 / $61.56	Professional	26	$61.56	$61.56	$61.56
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $151.51 / $151.51 / $151.51	Professional	TC	$151.51	$151.51	$151.51