Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.30 / $72.28 / $296.22	Facility	26	$51.30	$72.28	$296.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $290.51 / $467.34	Professional		$171.00	$290.51	$467.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $79.56 / $119.82	Professional	26	$51.30	$79.56	$119.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $212.72 / $350.78	Professional	TC	$119.70	$212.72	$350.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $260.01 / $267.45 / $267.45	Professional		$260.01	$267.45	$267.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.91 / $137.82 / $142.31	Professional	26	$67.91	$137.82	$142.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.97 / $96.97 / $261.60	Facility	26	$96.97	$96.97	$261.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.32 / $385.84 / $800.14	Professional		$216.32	$385.84	$800.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.20 / $91.71 / $176.70	Professional	26	$60.20	$91.71	$176.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $163.40 / $281.10 / $621.91	Professional	TC	$163.40	$281.10	$621.91
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $96.07 / $96.07 / $96.07	Facility	26	$96.07	$96.07	$96.07
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $226.96 / $350.52 / $446.95	Professional		$226.96	$350.52	$446.95
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $59.00 / $93.67 / $126.09	Professional	26	$59.00	$93.67	$126.09
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $160.38 / $261.52 / $359.84	Professional	TC	$160.38	$261.52	$359.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.72 / $182.43 / $338.95	Professional		$94.72	$182.43	$338.95
United Facility/Professional Professional Modifier Low / Median / High Price $239.64 / $354.96 / $655.38	Professional		$239.64	$354.96	$655.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.84 / $76.86 / $157.19	Professional	26	$66.84	$76.86	$157.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $172.88 / $268.32 / $503.40	Professional	TC	$172.88	$268.32	$503.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $182.67 / $182.67 / $182.67	Professional		$182.67	$182.67	$182.67
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $48.93 / $48.93 / $48.93	Professional	26	$48.93	$48.93	$48.93
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $133.72 / $133.72 / $133.72	Professional	TC	$133.72	$133.72	$133.72