Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $61.92 / $201.62	Facility	26	$51.29	$61.92	$201.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $272.61 / $415.33	Professional		$171.00	$272.61	$415.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.00 / $55.68 / $88.65	Professional	26	$50.00	$55.68	$88.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $209.47 / $335.76	Professional	TC	$119.70	$209.47	$335.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.97 / $188.20 / $222.79	Professional		$149.97	$188.20	$222.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.66 / $45.22 / $90.49	Professional	26	$31.66	$45.22	$90.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.64 / $65.64 / $177.59	Facility	26	$65.64	$65.64	$177.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.53 / $324.89 / $657.24	Professional		$179.53	$324.89	$657.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.82 / $69.47 / $122.64	Professional	26	$40.82	$69.47	$122.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.55 / $250.40 / $515.55	Professional	TC	$147.55	$250.40	$515.55
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $64.68 / $64.68 / $64.68	Facility	26	$64.68	$64.68	$64.68
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $189.11 / $305.43 / $422.11	Professional		$189.11	$305.43	$422.11
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $45.28 / $67.11 / $84.89	Professional	26	$45.28	$67.11	$84.89
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $143.82 / $238.84 / $342.86	Professional	TC	$143.82	$238.84	$342.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.81 / $191.69 / $331.91	Professional		$38.81	$191.69	$331.91
United Facility/Professional Professional Modifier Low / Median / High Price $203.77 / $280.33 / $544.91	Professional		$203.77	$280.33	$544.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.22 / $51.88 / $106.44	Professional	26	$45.22	$51.88	$106.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $153.82 / $223.15 / $438.38	Professional	TC	$153.82	$223.15	$438.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $154.97 / $154.97 / $154.97	Professional		$154.97	$154.97	$154.97
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.86 / $33.86 / $33.86	Professional	26	$33.86	$33.86	$33.86
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $121.11 / $121.11 / $121.11	Professional	TC	$121.11	$121.11	$121.11