Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $59.22 / $222.70	Facility	26	$51.29	$59.22	$222.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $249.57 / $411.86	Professional		$171.00	$249.57	$411.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $60.08 / $107.73	Professional	26	$51.30	$60.08	$107.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $174.19 / $326.12	Professional	TC	$119.70	$174.19	$326.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.66 / $141.03 / $178.50	Professional		$92.66	$141.03	$178.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.17 / $55.97 / $133.46	Professional	26	$43.17	$55.97	$133.46
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $109.48 / $206.07 / $206.07	Professional	TC	$109.48	$206.07	$206.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.54 / $67.54 / $201.09	Facility	26	$67.54	$67.54	$201.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.37 / $294.99 / $602.83	Professional		$146.37	$294.99	$602.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.75 / $72.72 / $133.97	Professional	26	$41.75	$72.72	$133.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.22 / $217.00 / $478.44	Professional	TC	$104.22	$217.00	$478.44
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $73.26 / $73.26 / $73.26	Facility	26	$73.26	$73.26	$73.26
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $185.31 / $314.25 / $443.96	Professional		$185.31	$314.25	$443.96
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $51.27 / $75.22 / $96.16	Professional	26	$51.27	$75.22	$96.16
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $128.35 / $238.97 / $357.22	Professional	TC	$128.35	$238.97	$357.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $158.53 / $276.56	Professional		$41.40	$158.53	$276.56
United Facility/Professional Professional Modifier Low / Median / High Price $181.42 / $269.64 / $536.74	Professional		$181.42	$269.64	$536.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.30 / $58.74 / $120.82	Professional	26	$49.30	$58.74	$120.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.22 / $198.36 / $425.48	Professional	TC	$125.22	$198.36	$425.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $140.49 / $140.49 / $140.49	Professional		$140.49	$140.49	$140.49
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $40.71 / $40.71 / $40.71	Professional	26	$40.71	$40.71	$40.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $99.79 / $99.79 / $99.79	Professional	TC	$99.79	$99.79	$99.79