Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $65.09 / $270.77	Facility	26	$62.50	$65.09	$270.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $401.58 / $600.00	Professional		$250.00	$401.58	$600.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $107.53 / $198.00	Professional	26	$62.50	$107.53	$198.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $297.92 / $450.05	Professional	TC	$187.50	$297.92	$450.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $187.00 / $222.56 / $657.41	Professional		$187.00	$222.56	$657.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.11 / $88.76 / $159.28	Professional	26	$57.11	$88.76	$159.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.30 / $88.30 / $236.62	Facility	26	$88.30	$88.30	$236.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.92 / $444.17 / $884.33	Professional		$234.92	$444.17	$884.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.56 / $94.95 / $158.62	Professional	26	$54.56	$94.95	$158.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $178.83 / $349.89 / $724.22	Professional	TC	$178.83	$349.89	$724.22
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $86.16 / $86.16 / $86.16	Facility	26	$86.16	$86.16	$86.16
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $274.85 / $434.47 / $620.19	Professional		$274.85	$434.47	$620.19
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $54.60 / $84.01 / $115.50	Professional	26	$54.60	$84.01	$115.50
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $214.54 / $356.29 / $527.78	Professional	TC	$214.54	$356.29	$527.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $237.27 / $434.42	Professional		$95.09	$237.27	$434.42
United Facility/Professional Professional Modifier Low / Median / High Price $280.88 / $389.93 / $745.73	Professional		$280.88	$389.93	$745.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.03 / $70.56 / $147.54	Professional	26	$60.03	$70.56	$147.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.46 / $312.68 / $647.21	Professional	TC	$217.46	$312.68	$647.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $224.58 / $224.58 / $224.58	Professional		$224.58	$224.58	$224.58
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $53.18 / $53.18 / $53.18	Professional	26	$53.18	$53.18	$53.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $171.39 / $171.39 / $171.39	Professional	TC	$171.39	$171.39	$171.39