Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.30 / $161.72	Facility	26	$51.29	$51.30	$161.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.53 / $188.58 / $394.25	Professional		$144.53	$188.58	$394.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.83 / $51.30 / $120.15	Professional	26	$43.83	$51.30	$120.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $103.05 / $131.68 / $231.46	Professional	TC	$103.05	$131.68	$231.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.86 / $109.18 / $238.60	Professional		$94.86	$109.18	$238.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.22 / $48.44 / $97.36	Professional	26	$34.22	$48.44	$97.36
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $80.73 / $80.73 / $80.73	Professional	TC	$80.73	$80.73	$80.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $146.02	Facility	26	$54.02	$54.02	$146.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.66 / $218.49 / $420.06	Professional		$116.66	$218.49	$420.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.13 / $57.00 / $101.50	Professional	26	$33.13	$57.00	$101.50
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $231.34 / $231.34 / $231.34	Professional	50	$231.34	$231.34	$231.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $86.21 / $158.21 / $313.38	Professional	TC	$86.21	$158.21	$313.38
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $53.23 / $53.23 / $53.23	Facility	26	$53.23	$53.23	$53.23
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $130.81 / $205.54 / $280.31	Professional		$130.81	$205.54	$280.31
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $37.26 / $55.39 / $69.87	Professional	26	$37.26	$55.39	$69.87
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $93.55 / $147.49 / $200.46	Professional	TC	$93.55	$147.49	$200.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.32 / $121.99 / $222.41	Professional		$36.32	$121.99	$222.41
United Facility/Professional Professional Modifier Low / Median / High Price $139.72 / $185.31 / $344.91	Professional		$139.72	$185.31	$344.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.95 / $44.12 / $87.74	Professional	26	$37.95	$44.12	$87.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.73 / $136.57 / $260.69	Professional	TC	$98.73	$136.57	$260.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $99.87 / $99.87 / $99.87	Professional		$99.87	$99.87	$99.87
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $28.19 / $28.19 / $28.19	Professional	26	$28.19	$28.19	$28.19
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $71.68 / $71.68 / $71.68	Professional	TC	$71.68	$71.68	$71.68