Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $74.13 / $257.04	Facility	26	$61.66	$74.13	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $389.05 / $1,122.02	Professional		$199.53	$389.05	$1,122.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $117.49 / $275.42	Professional	26	$63.10	$117.49	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $218.78 / $457.09	Professional	TC	$125.89	$218.78	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $147.91 / $234.42	Professional		$72.44	$147.91	$234.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $123.03	Professional	26	$52.48	$72.44	$123.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $97.72 / $147.91	Professional	TC	$63.10	$97.72	$147.91
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 / $588.84	Professional	TC	$95.50	$223.87	$588.84
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 $134.90 / $251.19 / $501.19	Professional		$134.90	$251.19	$501.19
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 / $158.49 / $407.38	Professional	TC	$87.10	$158.49	$407.38
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 / $588.84	Professional		$169.82	$263.03	$588.84
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 / $457.09	Professional	TC	$109.65	$165.96	$457.09
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