Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $75.86 / $602.56	Facility	26	$51.29	$75.86	$602.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $257.04 / $436.52	Professional		$169.82	$257.04	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $61.66 / $134.90	Professional	26	$51.29	$61.66	$134.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $177.83 / $346.74	Professional	TC	$120.23	$177.83	$346.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $158.49	Professional		$95.50	$134.90	$158.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $63.10 / $104.71	Professional	26	$45.71	$63.10	$104.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $117.49	Facility	26	$14.45	$67.61	$117.49
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 / $128.82	Professional	26	$42.66	$70.79	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $213.80 / $478.63	Professional	TC	$112.20	$213.80	$478.63
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $67.61 / $67.61	Facility	26	$67.61	$67.61	$67.61
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $275.42 / $426.58	Professional		$141.25	$275.42	$426.58
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $61.66 / $89.13	Professional	26	$41.69	$61.66	$89.13
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 / $97.72 / $251.19	Professional		$32.36	$97.72	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $269.15 / $489.78	Professional		$177.83	$269.15	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $54.95 / $104.71	Professional	26	$46.77	$54.95	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $199.53 / $389.05	Professional	TC	$128.82	$199.53	$389.05
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 $45.71 / $45.71 / $58.88	Professional	26	$45.71	$45.71	$58.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $107.15 / $131.83	Professional	TC	$107.15	$107.15	$131.83