Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $108.90 / $353.49	Facility	26	$62.50	$108.90	$353.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $425.00 / $725.67	Professional		$250.00	$425.00	$725.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $119.21 / $221.87	Professional	26	$62.50	$119.21	$221.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $320.49 / $532.17	Professional	TC	$187.50	$320.49	$532.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $231.98 / $291.91 / $594.14	Professional		$231.98	$291.91	$594.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.00 / $148.44 / $207.94	Professional	26	$76.00	$148.44	$207.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.87 / $116.87 / $312.18	Facility	26	$116.87	$116.87	$312.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.35 / $565.49 / $1,302.18	Professional		$291.35	$565.49	$1,302.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.40 / $125.47 / $207.00	Professional	26	$72.40	$125.47	$207.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.89 / $429.32 / $1,098.08	Professional	TC	$216.89	$429.32	$1,098.08
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $114.40 / $114.40 / $114.40	Facility	26	$114.40	$114.40	$114.40
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $341.82 / $567.66 / $958.33	Professional		$341.82	$567.66	$958.33
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $73.90 / $111.54 / $153.35	Professional	26	$73.90	$111.54	$153.35
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $261.74 / $434.67 / $835.73	Professional	TC	$261.74	$434.67	$835.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $294.32 / $512.75	Professional		$95.09	$294.32	$512.75
United Facility/Professional Professional Modifier Low / Median / High Price $352.20 / $504.97 / $1,113.10	Professional		$352.20	$504.97	$1,113.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.06 / $91.15 / $202.96	Professional	26	$79.06	$91.15	$202.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $264.64 / $384.29 / $893.78	Professional	TC	$264.64	$384.29	$893.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $279.30 / $279.30 / $279.30	Professional		$279.30	$279.30	$279.30
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $70.81 / $70.81 / $70.81	Professional	26	$70.81	$70.81	$70.81
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $208.48 / $208.48 / $208.48	Professional	TC	$208.48	$208.48	$208.48