Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $71.88 / $246.19	Facility	26	$62.50	$71.88	$246.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $419.64 / $646.51	Professional		$250.00	$419.64	$646.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $104.00 / $179.10	Professional	26	$62.50	$104.00	$179.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $305.00 / $500.05	Professional	TC	$187.50	$305.00	$500.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.54 / $228.87 / $556.40	Professional		$194.54	$228.87	$556.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.46 / $90.87 / $144.82	Professional	26	$48.46	$90.87	$144.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.26 / $80.26 / $214.17	Facility	26	$80.26	$80.26	$214.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.20 / $575.00 / $1,267.60	Professional		$246.20	$575.00	$1,267.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.68 / $96.38 / $164.70	Professional	26	$49.68	$96.38	$164.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.89 / $458.95 / $1,133.69	Professional	TC	$199.89	$458.95	$1,133.69
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $95.45 / $95.45 / $95.45	Facility	26	$95.45	$95.45	$95.45
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $379.23 / $690.53 / $993.13	Professional		$379.23	$690.53	$993.13
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $66.81 / $97.85 / $127.95	Professional	26	$66.81	$97.85	$127.95
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $320.18 / $610.60 / $871.94	Professional	TC	$320.18	$610.60	$871.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $255.40 / $437.03	Professional		$62.75	$255.40	$437.03
United Facility/Professional Professional Modifier Low / Median / High Price $289.42 / $488.41 / $1,095.20	Professional		$289.42	$488.41	$1,095.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.98 / $73.80 / $139.49	Professional	26	$60.98	$73.80	$139.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $228.44 / $393.45 / $975.85	Professional	TC	$228.44	$393.45	$975.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $256.23 / $256.23 / $256.23	Professional		$256.23	$256.23	$256.23
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $52.30 / $52.30 / $52.30	Professional	26	$52.30	$52.30	$52.30
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $203.93 / $203.93 / $203.93	Professional	TC	$203.93	$203.93	$203.93