Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $93.81 / $294.93	Facility	26	$62.50	$93.81	$294.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $375.00 / $546.25	Professional		$250.00	$375.00	$546.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $104.00 / $154.00	Professional	26	$62.50	$104.00	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $269.55 / $377.05	Professional	TC	$187.50	$269.55	$377.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.78 / $179.14 / $575.79	Professional		$163.78	$179.14	$575.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.37 / $123.14 / $178.87	Professional	26	$64.37	$123.14	$178.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.82 / $96.82 / $260.52	Facility	26	$96.82	$96.82	$260.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.84 / $413.45 / $870.58	Professional		$202.84	$413.45	$870.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.16 / $104.96 / $175.33	Professional	26	$60.16	$104.96	$175.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $140.91 / $294.00 / $708.36	Professional	TC	$140.91	$294.00	$708.36
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $95.36 / $95.36 / $95.36	Facility	26	$95.36	$95.36	$95.36
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $234.36 / $389.21 / $644.41	Professional		$234.36	$389.21	$644.41
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $66.75 / $99.22 / $127.83	Professional	26	$66.75	$99.22	$127.83
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $173.59 / $278.35 / $504.68	Professional	TC	$173.59	$278.35	$504.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $203.78 / $357.88	Professional		$95.09	$203.78	$357.88
United Facility/Professional Professional Modifier Low / Median / High Price $240.14 / $367.70 / $756.69	Professional		$240.14	$367.70	$756.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.20 / $76.19 / $161.69	Professional	26	$66.20	$76.19	$161.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.21 / $254.81 / $565.44	Professional	TC	$169.21	$254.81	$565.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $196.90 / $196.90 / $196.90	Professional		$196.90	$196.90	$196.90
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $59.19 / $59.19 / $59.19	Professional	26	$59.19	$59.19	$59.19
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $137.71 / $137.71 / $137.71	Professional	TC	$137.71	$137.71	$137.71