Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $62.25 / $196.66	Facility	26	$51.29	$62.25	$196.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $219.17 / $347.11	Professional		$171.00	$219.17	$347.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $57.84 / $115.24	Professional	26	$51.29	$57.84	$115.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $113.33 / $142.24 / $269.75	Professional	TC	$113.33	$142.24	$269.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.31 / $128.12 / $128.12	Professional		$115.31	$128.12	$128.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.28 / $66.25 / $103.00	Professional	26	$43.28	$66.25	$103.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.98 / $65.98 / $177.59	Facility	26	$65.98	$65.98	$177.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.99 / $251.12 / $503.95	Professional		$125.99	$251.12	$503.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.82 / $64.89 / $120.60	Professional	26	$40.82	$64.89	$120.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.79 / $187.67 / $386.80	Professional	TC	$84.79	$187.67	$386.80
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $64.68 / $64.68 / $64.68	Facility	26	$64.68	$64.68	$64.68
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $160.15 / $257.77 / $360.64	Professional		$160.15	$257.77	$360.64
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $45.28 / $66.30 / $84.89	Professional	26	$45.28	$66.30	$84.89
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 / $124.58 / $223.01	Professional		$41.40	$124.58	$223.01
United Facility/Professional Professional Modifier Low / Median / High Price $153.30 / $223.20 / $423.66	Professional		$153.30	$223.20	$423.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.96 / $51.88 / $107.05	Professional	26	$44.96	$51.88	$107.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.36 / $160.36 / $339.29	Professional	TC	$103.36	$160.36	$339.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $130.76 / $130.76 / $130.76	Professional		$130.76	$130.76	$130.76
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $43.00 / $43.00 / $43.00	Professional	26	$43.00	$43.00	$43.00
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $87.76 / $87.76 / $87.76	Professional	TC	$87.76	$87.76	$87.76