Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.07 / $62.50 / $248.52	Facility	26	$60.07	$62.50	$248.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $349.44 / $525.00	Professional		$250.00	$349.44	$525.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $89.08 / $154.29	Professional	26	$62.50	$89.08	$154.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.19 / $249.62 / $385.24	Professional	TC	$186.19	$249.62	$385.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.71 / $111.88 / $146.19	Professional	26	$53.71	$111.88	$146.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.40 / $81.40 / $218.57	Facility	26	$81.40	$81.40	$218.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.35 / $406.78 / $779.99	Professional		$184.35	$406.78	$779.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.33 / $74.23 / $139.00	Professional	26	$49.33	$74.23	$139.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $133.29 / $325.50 / $673.23	Professional	TC	$133.29	$325.50	$673.23
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 $275.17 / $460.87 / $621.64	Professional		$275.17	$460.87	$621.64
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $47.78 / $67.00 / $90.15	Professional	26	$47.78	$67.00	$90.15
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $216.87 / $392.11 / $528.89	Professional	TC	$216.87	$392.11	$528.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.27 / $182.08 / $336.61	Professional		$94.27	$182.08	$336.61
United Facility/Professional Professional Modifier Low / Median / High Price $215.04 / $354.00 / $696.52	Professional		$215.04	$354.00	$696.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.82 / $63.50 / $141.58	Professional	26	$45.82	$63.50	$141.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $153.49 / $273.19 / $592.07	Professional	TC	$153.49	$273.19	$592.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $191.11 / $191.11 / $191.11	Professional		$191.11	$191.11	$191.11
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $53.06 / $53.06 / $53.06	Professional	26	$53.06	$53.06	$53.06
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $138.05 / $138.05 / $138.05	Professional	TC	$138.05	$138.05	$138.05