Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $67.61 / $234.42	Facility	26	$51.29	$67.61	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $275.42 / $549.54	Professional		$169.82	$275.42	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $70.79 / $181.97	Professional	26	$51.29	$70.79	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $190.55 / $371.54	Professional	TC	$120.23	$190.55	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $141.25 / $190.55	Professional		$79.43	$141.25	$190.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $69.18 / $97.72	Professional	26	$43.65	$69.18	$97.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $102.33 / $251.19	Professional	TC	$93.33	$102.33	$251.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $114.82	Facility	26	$14.45	$67.61	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $288.40 / $616.60	Professional		$147.91	$288.40	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $70.79 / $138.04	Professional	26	$42.66	$70.79	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $208.93 / $478.63	Professional	TC	$109.65	$208.93	$478.63
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $72.44 / $72.44	Facility	26	$72.44	$72.44	$72.44
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $281.84 / $436.52	Professional		$141.25	$281.84	$436.52
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $66.07 / $97.72	Professional	26	$40.74	$66.07	$97.72
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $199.53 / $338.84	Professional	TC	$97.72	$199.53	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $93.33 / $251.19	Professional		$32.36	$93.33	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $269.15 / $489.78	Professional		$181.97	$269.15	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $60.26 / $114.82	Professional	26	$50.12	$60.26	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $199.53 / $371.54	Professional	TC	$125.89	$199.53	$371.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $190.55	Professional		$151.36	$151.36	$190.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $44.67 / $57.54	Professional	26	$44.67	$44.67	$57.54
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $107.15 / $131.83	Professional	TC	$107.15	$107.15	$131.83