Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $71.75 / $223.39	Facility	26	$62.50	$71.75	$223.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $402.08 / $603.00	Professional		$250.00	$402.08	$603.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $98.28 / $166.95	Professional	26	$62.50	$98.28	$166.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $282.87 / $441.00	Professional	TC	$187.50	$282.87	$441.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $196.74 / $226.14 / $463.32	Professional		$196.74	$226.14	$463.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.89 / $63.65 / $131.40	Professional	26	$46.89	$63.65	$131.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $197.06	Facility	26	$73.64	$73.64	$197.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.47 / $419.67 / $840.19	Professional		$228.47	$419.67	$840.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.58 / $78.68 / $134.09	Professional	26	$45.58	$78.68	$134.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.58 / $341.76 / $715.68	Professional	TC	$181.58	$341.76	$715.68
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $72.18 / $72.18 / $72.18	Facility	26	$72.18	$72.18	$72.18
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $265.58 / $412.60 / $545.39	Professional		$265.58	$412.60	$545.39
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $43.20 / $70.37 / $96.63	Professional	26	$43.20	$70.37	$96.63
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $215.05 / $337.94 / $469.40	Professional	TC	$215.05	$337.94	$469.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $227.93 / $411.18	Professional		$62.75	$227.93	$411.18
United Facility/Professional Professional Modifier Low / Median / High Price $271.95 / $366.48 / $716.74	Professional		$271.95	$366.48	$716.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.43 / $58.34 / $125.29	Professional	26	$49.43	$58.34	$125.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.55 / $310.88 / $602.14	Professional	TC	$218.55	$310.88	$602.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $184.29 / $184.29 / $184.29	Professional		$184.29	$184.29	$184.29
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $37.57 / $37.57 / $37.57	Professional	26	$37.57	$37.57	$37.57
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $146.72 / $146.72 / $146.72	Professional	TC	$146.72	$146.72	$146.72