Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $59.00 / $190.76	Facility	26	$51.29	$59.00	$190.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $240.54 / $354.91	Professional		$171.00	$240.54	$354.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.03 / $55.00 / $123.01	Professional	26	$49.03	$55.00	$123.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $178.14 / $276.56	Professional	TC	$119.70	$178.14	$276.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.82 / $158.47 / $308.66	Professional		$131.82	$158.47	$308.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $56.38 / $112.21	Professional	26	$39.97	$56.38	$112.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.89 / $62.89 / $169.53	Facility	26	$62.89	$62.89	$169.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.65 / $264.33 / $503.34	Professional		$142.65	$264.33	$503.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.95 / $62.02 / $115.11	Professional	26	$38.95	$62.02	$115.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $110.34 / $197.52 / $395.92	Professional	TC	$110.34	$197.52	$395.92
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $61.80 / $61.80 / $61.80	Facility	26	$61.80	$61.80	$61.80
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $161.94 / $250.67 / $333.27	Professional		$161.94	$250.67	$333.27
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $43.26 / $63.20 / $81.11	Professional	26	$43.26	$63.20	$81.11
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $118.69 / $186.51 / $254.33	Professional	TC	$118.69	$186.51	$254.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.97 / $156.71 / $276.56	Professional		$38.97	$156.71	$276.56
United Facility/Professional Professional Modifier Low / Median / High Price $171.61 / $225.92 / $427.01	Professional		$171.61	$225.92	$427.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.99 / $49.56 / $101.87	Professional	26	$42.99	$49.56	$101.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $126.32 / $170.38 / $333.46	Professional	TC	$126.32	$170.38	$333.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $132.19 / $132.19 / $132.19	Professional		$132.19	$132.19	$132.19
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $34.86 / $34.86 / $34.86	Professional	26	$34.86	$34.86	$34.86
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $97.32 / $97.32 / $97.32	Professional	TC	$97.32	$97.32	$97.32