Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.29 / $186.21	Facility	26	$51.29	$51.29	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $194.98 / $436.52	Professional		$114.82	$194.98	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $83.18 / $213.80	Professional	26	$51.29	$83.18	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $165.96 / $316.23	Professional	TC	$112.20	$165.96	$316.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $147.91 / $363.08	Professional		$109.65	$147.91	$363.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $52.48 / $89.13	Professional	26	$40.74	$52.48	$89.13
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 $123.03 / $239.88 / $501.19	Professional		$123.03	$239.88	$501.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $60.26 / $120.23	Professional	26	$38.90	$60.26	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $173.78 / $371.54	Professional	TC	$91.20	$173.78	$371.54
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 $120.23 / $234.42 / $331.13	Professional		$120.23	$234.42	$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 $79.43 / $162.18 / $251.19	Professional	TC	$79.43	$162.18	$251.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $81.28 / $208.93	Professional		$32.36	$81.28	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $218.78 / $389.05	Professional		$151.36	$218.78	$389.05
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 $104.71 / $162.18 / $281.84	Professional	TC	$104.71	$162.18	$281.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $162.18	Professional		$128.82	$128.82	$162.18
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $41.69 / $53.70	Professional	26	$41.69	$41.69	$53.70
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $87.10 / $107.15	Professional	TC	$87.10	$87.10	$107.15