Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $58.88 / $199.53	Facility	26	$51.29	$58.88	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $229.09 / $457.09	Professional		$128.82	$229.09	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $70.79 / $177.83	Professional	26	$51.29	$70.79	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $186.21 / $346.74	Professional	TC	$120.23	$186.21	$346.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $194.98 / $426.58	Professional		$173.78	$194.98	$426.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $54.95 / $87.10	Professional	26	$40.74	$54.95	$87.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $61.66 / $107.15	Facility	26	$13.49	$61.66	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $245.47 / $524.81	Professional		$147.91	$245.47	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $60.26 / $117.49	Professional	26	$38.90	$60.26	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $186.21 / $407.38	Professional	TC	$109.65	$186.21	$407.38
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $61.66 / $61.66	Facility	26	$61.66	$61.66	$61.66
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $239.88 / $331.13	Professional		$134.90	$239.88	$331.13
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $56.23 / $81.28	Professional	26	$38.02	$56.23	$81.28
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $177.83 / $245.47	Professional	TC	$97.72	$177.83	$245.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $91.20 / $251.19	Professional		$32.36	$91.20	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $223.87 / $407.38	Professional		$173.78	$223.87	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $50.12 / $97.72	Professional	26	$43.65	$50.12	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $173.78 / $323.59	Professional	TC	$125.89	$173.78	$323.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $194.98	Professional		$144.54	$144.54	$194.98
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $38.90 / $53.70	Professional	26	$38.90	$38.90	$53.70
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $107.15 / $141.25	Professional	TC	$107.15	$107.15	$141.25