Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.30 / $192.74	Facility	26	$51.29	$51.30	$192.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.55 / $232.09 / $558.10	Professional		$165.55	$232.09	$558.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.15 / $58.61 / $215.40	Professional	26	$51.15	$58.61	$215.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.11 / $146.74 / $285.00	Professional	TC	$114.11	$146.74	$285.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.16 / $119.76 / $215.56	Professional		$63.16	$119.76	$215.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.07 / $55.60 / $100.40	Professional	26	$39.07	$55.60	$100.40
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.62 / $89.49 / $104.94	Professional	TC	$44.62	$89.49	$104.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.24 / $63.24 / $180.58	Facility	26	$63.24	$63.24	$180.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.33 / $244.03 / $497.31	Professional		$124.33	$244.03	$497.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.17 / $64.90 / $125.10	Professional	26	$39.17	$64.90	$125.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.52 / $175.96 / $386.80	Professional	TC	$84.52	$175.96	$386.80
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $66.14 / $66.14 / $66.14	Facility	26	$66.14	$66.14	$66.14
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $157.91 / $257.93 / $360.60	Professional		$157.91	$257.93	$360.60
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $46.30 / $67.18 / $86.81	Professional	26	$46.30	$67.18	$86.81
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $104.94 / $194.04 / $285.86	Professional	TC	$104.94	$194.04	$285.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $124.22 / $223.01	Professional		$41.40	$124.22	$223.01
United Facility/Professional Professional Modifier Low / Median / High Price $153.61 / $227.68 / $419.58	Professional		$153.61	$227.68	$419.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.73 / $52.69 / $108.51	Professional	26	$44.73	$52.69	$108.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.55 / $159.82 / $334.18	Professional	TC	$102.55	$159.82	$334.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $117.36 / $117.36 / $117.36	Professional		$117.36	$117.36	$117.36
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $37.45 / $37.45 / $37.45	Professional	26	$37.45	$37.45	$37.45
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $79.91 / $79.91 / $79.91	Professional	TC	$79.91	$79.91	$79.91