Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $69.18 / $213.80	Facility	26	$61.66	$69.18	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $426.58 / $1,258.93	Professional		$199.53	$426.58	$1,258.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $114.82 / $263.03	Professional	26	$64.57	$114.82	$263.03
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $123.03 / $199.53 / $870.96	Professional	52	$123.03	$199.53	$870.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $218.78 / $478.63	Professional	TC	$123.03	$218.78	$478.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $151.36 / $288.40	Professional		$125.89	$151.36	$288.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $66.07 / $120.23	Professional	26	$52.48	$66.07	$120.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $95.50 / $218.78	Professional	TC	$79.43	$95.50	$218.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $138.04	Facility	26	$16.98	$79.43	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $323.59 / $707.95	Professional		$141.25	$323.59	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $91.20 / $158.49	Professional	26	$50.12	$91.20	$158.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $223.87 / $549.54	Professional	TC	$95.50	$223.87	$549.54
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $79.43 / $79.43	Facility	26	$79.43	$79.43	$79.43
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $251.19 / $467.74	Professional		$138.04	$251.19	$467.74
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $74.13 / $107.15	Professional	26	$47.86	$74.13	$107.15
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $162.18 / $389.05	Professional	TC	$87.10	$162.18	$389.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $95.50 / $234.42	Professional		$32.36	$95.50	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $263.03 / $562.34	Professional		$169.82	$263.03	$562.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $66.07 / $128.82	Professional	26	$56.23	$66.07	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $165.96 / $416.87	Professional	TC	$109.65	$165.96	$416.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $186.21	Professional		$147.91	$147.91	$186.21
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $53.70 / $67.61	Professional	26	$53.70	$53.70	$67.61
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $95.50 / $117.49	Professional	TC	$95.50	$95.50	$117.49