Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $91.20 / $309.03	Facility	26	$61.66	$91.20	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $478.63 / $1,412.54	Professional		$251.19	$478.63	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $138.04 / $295.12	Professional	26	$63.10	$138.04	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $338.84 / $794.33	Professional	TC	$186.21	$338.84	$794.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $275.42 / $588.84	Professional		$213.80	$275.42	$588.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $89.13 / $144.54	Professional	26	$63.10	$89.13	$144.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $165.96	Facility	26	$20.89	$97.72	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $537.03 / $1,288.25	Professional		$257.04	$537.03	$1,288.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $104.71 / $190.55	Professional	26	$60.26	$104.71	$190.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $426.58 / $1,096.48	Professional	TC	$213.80	$426.58	$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 $245.47 / $602.56 / $977.24	Professional		$245.47	$602.56	$977.24
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $89.13 / $128.82	Professional	26	$57.54	$89.13	$128.82
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $512.86 / $851.14	Professional	TC	$186.21	$512.86	$851.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $158.49 / $457.09	Professional		$32.36	$158.49	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $512.86 / $1,023.29	Professional		$302.00	$512.86	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $79.43 / $154.88	Professional	26	$66.07	$79.43	$154.88
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 $269.15 / $269.15 / $331.13	Professional		$269.15	$269.15	$331.13
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $64.57 / $83.18	Professional	26	$64.57	$64.57	$83.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $204.17 / $251.19	Professional	TC	$204.17	$204.17	$251.19