Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $88.77 / $354.00	Facility	26	$62.50	$88.77	$354.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $427.86 / $895.94	Professional		$250.00	$427.86	$895.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $126.00 / $298.89	Professional	26	$62.50	$126.00	$298.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $299.00 / $499.00	Professional	TC	$187.50	$299.00	$499.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.00 / $254.54 / $521.53	Professional		$199.00	$254.54	$521.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.94 / $105.48 / $191.55	Professional	26	$76.94	$105.48	$191.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $165.04 / $202.30 / $274.08	Professional	TC	$165.04	$202.30	$274.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $319.62	Facility	26	$118.86	$118.86	$319.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $253.44 / $535.00 / $1,300.00	Professional		$253.44	$535.00	$1,300.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.59 / $126.00 / $215.45	Professional	26	$73.59	$126.00	$215.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $183.41 / $396.90 / $1,115.54	Professional	TC	$183.41	$396.90	$1,115.54
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $120.08 / $120.08 / $120.08	Facility	26	$120.08	$120.08	$120.08
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $361.03 / $610.47 / $1,022.55	Professional		$361.03	$610.47	$1,022.55
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $74.98 / $117.08 / $160.91	Professional	26	$74.98	$117.08	$160.91
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $260.39 / $470.88 / $844.34	Professional	TC	$260.39	$470.88	$844.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $237.27 / $439.20	Professional		$95.09	$237.27	$439.20
United Facility/Professional Professional Modifier Low / Median / High Price $305.02 / $462.11 / $1,080.07	Professional		$305.02	$462.11	$1,080.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.37 / $95.10 / $204.21	Professional	26	$82.37	$95.10	$204.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $215.75 / $349.00 / $930.18	Professional	TC	$215.75	$349.00	$930.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $254.42 / $254.42 / $254.42	Professional		$254.42	$254.42	$254.42
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $75.42 / $75.42 / $75.42	Professional	26	$75.42	$75.42	$75.42
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $179.00 / $179.00 / $179.00	Professional	TC	$179.00	$179.00	$179.00