Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $114.82 / $389.05	Facility	26	$61.66	$114.82	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $524.81 / $1,513.56	Professional		$251.19	$524.81	$1,513.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $144.54 / $323.59	Professional	26	$63.10	$144.54	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $380.19 / $870.96	Professional	TC	$186.21	$380.19	$870.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $363.08 / $562.34	Professional		$309.03	$363.08	$562.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $154.88 / $186.21	Professional	26	$81.28	$154.88	$186.21
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $660.69 / $660.69 / $660.69	Professional	TC	$660.69	$660.69	$660.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $123.03 / $208.93	Facility	26	$26.30	$123.03	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $630.96 / $1,445.44	Professional		$354.81	$630.96	$1,445.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $125.89 / $223.87	Professional	26	$75.86	$125.89	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $512.86 / $1,230.27	Professional	TC	$295.12	$512.86	$1,230.27
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $120.23 / $120.23 / $120.23	Facility	26	$120.23	$120.23	$120.23
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $616.60 / $1,000.00	Professional		$331.13	$616.60	$1,000.00
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $104.71 / $162.18	Professional	26	$74.13	$104.71	$162.18
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $489.78 / $851.14	Professional	TC	$257.04	$489.78	$851.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $199.53 / $630.96	Professional		$32.36	$199.53	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $616.60 / $1,202.26	Professional		$426.58	$616.60	$1,202.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $97.72 / $194.98	Professional	26	$83.18	$97.72	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $501.19 / $954.99	Professional	TC	$338.84	$501.19	$954.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $363.08 / $446.68	Professional		$363.08	$363.08	$446.68
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $81.28 / $104.71	Professional	26	$81.28	$81.28	$104.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $281.84 / $338.84	Professional	TC	$281.84	$281.84	$338.84