Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.29 / $147.91	Facility	26	$51.29	$51.29	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $169.82 / $575.44	Professional		$64.57	$169.82	$575.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $67.61 / $181.97	Professional	26	$44.67	$67.61	$181.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.65 / $199.53 / $354.81	Professional	50	$43.65	$199.53	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $138.04 / $288.40	Professional	TC	$102.33	$138.04	$288.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $131.83 / $257.04	Professional		$104.71	$131.83	$257.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $48.98 / $77.62	Professional	26	$34.67	$48.98	$77.62
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $162.18 / $162.18 / $162.18	Professional	50	$162.18	$162.18	$162.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $81.28 / $83.18	Professional	TC	$81.28	$81.28	$83.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $53.70 / $91.20	Facility	26	$11.48	$53.70	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $204.17 / $426.58	Professional		$120.23	$204.17	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $57.54 / $107.15	Professional	26	$33.11	$57.54	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $151.36 / $323.59	Professional	TC	$87.10	$151.36	$323.59
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $53.70 / $53.70	Facility	26	$53.70	$53.70	$53.70
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $194.98 / $269.15	Professional		$109.65	$194.98	$269.15
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $50.12 / $70.79	Professional	26	$33.11	$50.12	$70.79
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $138.04 / $199.53	Professional	TC	$77.62	$138.04	$199.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $70.79 / $194.98	Professional		$32.36	$70.79	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $186.21 / $338.84	Professional		$141.25	$186.21	$338.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $44.67 / $85.11	Professional	26	$38.02	$44.67	$85.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $138.04 / $257.04	Professional	TC	$97.72	$138.04	$257.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $147.91	Professional		$109.65	$109.65	$147.91
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $31.62 / $46.77	Professional	26	$31.62	$31.62	$46.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $77.62 / $102.33	Professional	TC	$77.62	$77.62	$102.33