Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.91 / $64.86 / $199.26	Facility	26	$60.91	$64.86	$199.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.82 / $370.50 / $525.00	Professional		$228.82	$370.50	$525.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.22 / $86.60 / $146.69	Professional	26	$58.22	$86.60	$146.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.73 / $258.02 / $369.35	Professional	TC	$168.73	$258.02	$369.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.41 / $163.01 / $333.98	Professional		$130.41	$163.01	$333.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.02 / $81.86 / $120.84	Professional	26	$43.02	$81.86	$120.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $175.54	Facility	26	$64.84	$64.84	$175.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.06 / $378.54 / $743.70	Professional		$161.06	$378.54	$743.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.34 / $70.18 / $119.61	Professional	26	$40.34	$70.18	$119.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.98 / $297.50 / $653.03	Professional	TC	$124.98	$297.50	$653.03
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 $240.99 / $439.60 / $592.95	Professional		$240.99	$439.60	$592.95
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $44.78 / $67.00 / $89.16	Professional	26	$44.78	$67.00	$89.16
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $196.82 / $372.82 / $500.20	Professional	TC	$196.82	$372.82	$500.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.36 / $180.73 / $296.48	Professional		$41.36	$180.73	$296.48
United Facility/Professional Professional Modifier Low / Median / High Price $192.18 / $318.64 / $644.77	Professional		$192.18	$318.64	$644.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.23 / $51.93 / $108.57	Professional	26	$44.23	$51.93	$108.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $142.83 / $257.95 / $558.79	Professional	TC	$142.83	$257.95	$558.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $167.47 / $167.47 / $167.47	Professional		$167.47	$167.47	$167.47
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 $125.23 / $125.23 / $125.23	Professional	TC	$125.23	$125.23	$125.23