Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $63.69 / $193.34	Facility	26	$62.50	$63.69	$193.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.48 / $375.00 / $547.09	Professional		$228.48	$375.00	$547.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.34 / $86.87 / $155.65	Professional	26	$58.34	$86.87	$155.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.39 / $258.55 / $388.07	Professional	TC	$168.39	$258.55	$388.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $127.24 / $162.10 / $357.45	Professional		$127.24	$162.10	$357.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.97 / $73.25 / $116.57	Professional	26	$37.97	$73.25	$116.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $174.56	Facility	26	$64.84	$64.84	$174.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.82 / $377.18 / $744.22	Professional		$160.82	$377.18	$744.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.34 / $70.31 / $119.61	Professional	26	$40.34	$70.31	$119.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.50 / $297.50 / $654.44	Professional	TC	$124.50	$297.50	$654.44
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $63.97 / $63.97 / $63.97	Facility	26	$63.97	$63.97	$63.97
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $240.28 / $438.45 / $590.29	Professional		$240.28	$438.45	$590.29
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $44.78 / $66.56 / $85.75	Professional	26	$44.78	$66.56	$85.75
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $196.42 / $370.84 / $498.79	Professional	TC	$196.42	$370.84	$498.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.36 / $180.80 / $297.03	Professional		$41.36	$180.80	$297.03
United Facility/Professional Professional Modifier Low / Median / High Price $191.37 / $323.73 / $667.23	Professional		$191.37	$323.73	$667.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.38 / $50.59 / $107.98	Professional	26	$43.38	$50.59	$107.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $142.29 / $256.85 / $592.96	Professional	TC	$142.29	$256.85	$592.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $167.22 / $167.22 / $167.22	Professional		$167.22	$167.22	$167.22
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $42.24 / $42.24 / $42.24	Professional	26	$42.24	$42.24	$42.24
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $124.97 / $124.97 / $124.97	Professional	TC	$124.97	$124.97	$124.97