Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $63.10 / $251.19	Facility	26	$61.66	$63.10	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $467.74 / $1,288.25	Professional		$251.19	$467.74	$1,288.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $120.23 / $269.15	Professional	26	$63.10	$120.23	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $338.84 / $812.83	Professional	TC	$186.21	$338.84	$812.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $245.47 / $338.84	Professional		$204.17	$245.47	$338.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $81.28 / $123.03	Professional	26	$51.29	$81.28	$123.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $138.04	Facility	26	$16.98	$79.43	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $537.03 / $1,258.93	Professional		$245.47	$537.03	$1,258.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $97.72 / $173.78	Professional	26	$51.29	$97.72	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $416.87 / $1,096.48	Professional	TC	$213.80	$416.87	$1,096.48
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Facility	26	$95.50	$95.50	$95.50
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $602.56 / $977.24	Professional		$234.42	$602.56	$977.24
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $85.11 / $128.82	Professional	26	$47.86	$85.11	$128.82
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $501.19 / $851.14	Professional	TC	$186.21	$501.19	$851.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $128.82 / $446.68	Professional		$32.36	$128.82	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $501.19 / $1,023.29	Professional		$288.40	$501.19	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $74.13 / $138.04	Professional	26	$60.26	$74.13	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $407.38 / $870.96	Professional	TC	$229.09	$407.38	$870.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $316.23	Professional		$257.04	$257.04	$316.23
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $53.70 / $67.61	Professional	26	$53.70	$53.70	$67.61
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $204.17 / $251.19	Professional	TC	$204.17	$204.17	$251.19