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 / $707.72	Professional		$250.00	$425.00	$707.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $127.50 / $344.64	Professional	26	$62.50	$127.50	$344.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $282.87 / $462.42	Professional	TC	$187.50	$282.87	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $193.74 / $225.12 / $496.19	Professional		$193.74	$225.12	$496.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.98 / $142.40 / $222.70	Professional	26	$80.98	$142.40	$222.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $332.66	Facility	26	$124.22	$124.22	$332.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.89 / $492.11 / $1,272.71	Professional		$239.89	$492.11	$1,272.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.95 / $126.00 / $228.13	Professional	26	$76.95	$126.00	$228.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $160.72 / $340.20 / $1,108.40	Professional	TC	$160.72	$340.20	$1,108.40
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $121.89 / $121.89 / $121.89	Facility	26	$121.89	$121.89	$121.89
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $285.60 / $457.95 / $976.21	Professional		$285.60	$457.95	$976.21
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $85.32 / $129.51 / $163.50	Professional	26	$85.32	$129.51	$163.50
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $197.23 / $316.26 / $859.45	Professional	TC	$197.23	$316.26	$859.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $209.28 / $387.38	Professional		$95.09	$209.28	$387.38
United Facility/Professional Professional Modifier Low / Median / High Price $282.14 / $438.44 / $1,068.15	Professional		$282.14	$438.44	$1,068.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.09 / $99.70 / $214.50	Professional	26	$85.09	$99.70	$214.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $193.63 / $290.45 / $774.92	Professional	TC	$193.63	$290.45	$774.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $233.38 / $233.38 / $233.38	Professional		$233.38	$233.38	$233.38
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $76.29 / $76.29 / $76.29	Professional	26	$76.29	$76.29	$76.29
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $157.08 / $157.08 / $157.08	Professional	TC	$157.08	$157.08	$157.08