Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $91.25 / $298.36	Facility	26	$62.50	$91.25	$298.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $425.00 / $700.23	Professional		$250.00	$425.00	$700.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $110.12 / $207.39	Professional	26	$62.50	$110.12	$207.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $299.00 / $501.95	Professional	TC	$187.50	$299.00	$501.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $203.92 / $239.90 / $325.41	Professional		$203.92	$239.90	$325.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.78 / $94.64 / $175.50	Professional	26	$62.78	$94.64	$175.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.25 / $97.25 / $261.17	Facility	26	$97.25	$97.25	$261.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $258.45 / $584.00 / $1,270.64	Professional		$258.45	$584.00	$1,270.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.63 / $105.05 / $178.71	Professional	26	$60.63	$105.05	$178.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $201.33 / $461.29 / $1,134.69	Professional	TC	$201.33	$461.29	$1,134.69
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 $384.87 / $705.30 / $998.98	Professional		$384.87	$705.30	$998.98
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $66.81 / $98.49 / $127.95	Professional	26	$66.81	$98.49	$127.95
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $321.39 / $614.86 / $871.94	Professional	TC	$321.39	$614.86	$871.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $268.60 / $484.63	Professional		$95.09	$268.60	$484.63
United Facility/Professional Professional Modifier Low / Median / High Price $303.98 / $500.29 / $1,095.33	Professional		$303.98	$500.29	$1,095.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.95 / $77.44 / $161.53	Professional	26	$65.95	$77.44	$161.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $230.08 / $403.40 / $984.95	Professional	TC	$230.08	$403.40	$984.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $268.05 / $268.05 / $268.05	Professional		$268.05	$268.05	$268.05
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $63.37 / $63.37 / $63.37	Professional	26	$63.37	$63.37	$63.37
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $204.69 / $204.69 / $204.69	Professional	TC	$204.69	$204.69	$204.69