Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $92.82 / $367.37	Facility	26	$62.50	$92.82	$367.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $425.00 / $775.98	Professional		$250.00	$425.00	$775.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $126.00 / $314.76	Professional	26	$62.50	$126.00	$314.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $282.87 / $440.00	Professional	TC	$187.50	$282.87	$440.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.52 / $232.51 / $316.08	Professional		$194.52	$232.51	$316.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.98 / $123.01 / $229.44	Professional	26	$77.98	$123.01	$229.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $331.68	Facility	26	$124.22	$124.22	$331.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.85 / $500.96 / $1,355.68	Professional		$228.85	$500.96	$1,355.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.95 / $131.36 / $246.14	Professional	26	$76.95	$131.36	$246.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $161.68 / $350.88 / $1,120.83	Professional	TC	$161.68	$350.88	$1,120.83
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $121.52 / $121.52 / $121.52	Facility	26	$121.52	$121.52	$121.52
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $286.95 / $460.52 / $977.07	Professional		$286.95	$460.52	$977.07
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $85.06 / $130.62 / $164.66	Professional	26	$85.06	$130.62	$164.66
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $198.45 / $319.23 / $859.45	Professional	TC	$198.45	$319.23	$859.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.12 / $209.28 / $388.45	Professional		$95.12	$209.28	$388.45
United Facility/Professional Professional Modifier Low / Median / High Price $282.18 / $432.73 / $1,034.08	Professional		$282.18	$432.73	$1,034.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.15 / $102.50 / $216.45	Professional	26	$88.15	$102.50	$216.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.72 / $285.50 / $757.03	Professional	TC	$194.72	$285.50	$757.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $227.67 / $227.67 / $227.67	Professional		$227.67	$227.67	$227.67
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $74.12 / $74.12 / $74.12	Professional	26	$74.12	$74.12	$74.12
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $153.54 / $153.54 / $153.54	Professional	TC	$153.54	$153.54	$153.54