Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $73.37 / $292.56	Facility	26	$51.29	$73.37	$292.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $300.00 / $520.01	Professional		$171.00	$300.00	$520.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $88.70 / $349.39	Professional	26	$51.30	$88.70	$349.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $217.28 / $369.67	Professional	TC	$119.70	$217.28	$369.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $170.17 / $213.55 / $412.12	Professional		$170.17	$213.55	$412.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.58 / $98.18 / $176.87	Professional	26	$63.58	$98.18	$176.87
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $146.84 / $156.34 / $156.34	Professional	TC	$146.84	$156.34	$156.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.41 / $98.41 / $264.14	Facility	26	$98.41	$98.41	$264.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.96 / $373.63 / $782.99	Professional		$201.96	$373.63	$782.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.11 / $94.16 / $180.14	Professional	26	$61.11	$94.16	$180.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.22 / $273.99 / $620.05	Professional	TC	$147.22	$273.99	$620.05
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $96.54 / $96.54 / $96.54	Facility	26	$96.54	$96.54	$96.54
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $218.76 / $343.77 / $458.07	Professional		$218.76	$343.77	$458.07
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $58.37 / $94.13 / $126.71	Professional	26	$58.37	$94.13	$126.71
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $156.59 / $251.77 / $369.87	Professional	TC	$156.59	$251.77	$369.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.79 / $182.43 / $336.61	Professional		$94.79	$182.43	$336.61
United Facility/Professional Professional Modifier Low / Median / High Price $235.11 / $333.57 / $660.19	Professional		$235.11	$333.57	$660.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.43 / $79.56 / $172.72	Professional	26	$69.43	$79.56	$172.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $160.79 / $245.72 / $495.81	Professional	TC	$160.79	$245.72	$495.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $179.17 / $179.17 / $179.17	Professional		$179.17	$179.17	$179.17
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $52.76 / $52.76 / $52.76	Professional	26	$52.76	$52.76	$52.76
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $126.41 / $126.41 / $126.41	Professional	TC	$126.41	$126.41	$126.41