Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $74.13 / $323.59	Facility	26	$51.29	$74.13	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $295.12 / $602.56	Professional		$169.82	$295.12	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $104.71 / $346.74	Professional	26	$51.29	$104.71	$346.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,698.24 / $1,819.70 / $2,951.21	Professional	50	$1,698.24	$1,819.70	$2,951.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $218.78 / $416.87	Professional	TC	$120.23	$218.78	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $257.04	Professional		$177.83	$177.83	$257.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $120.23 / $177.83	Professional	26	$69.18	$120.23	$177.83
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $389.05 / $389.05 / $389.05	Professional	50	$389.05	$389.05	$389.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $102.33 / $173.78	Facility	26	$21.88	$102.33	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $380.19 / $851.14	Professional		$234.42	$380.19	$851.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $91.20 / $190.55	Professional	26	$63.10	$91.20	$190.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $295.12 / $645.65	Professional	TC	$165.96	$295.12	$645.65
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $354.81 / $512.86	Professional		$218.78	$354.81	$512.86
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $85.11 / $131.83	Professional	26	$61.66	$85.11	$131.83
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $263.03 / $380.19	Professional	TC	$165.96	$263.03	$380.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $144.54 / $398.11	Professional		$32.36	$144.54	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $371.54 / $660.69	Professional		$275.42	$371.54	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $81.28 / $158.49	Professional	26	$70.79	$81.28	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $281.84 / $524.81	Professional	TC	$199.53	$281.84	$524.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $257.04	Professional		$223.87	$223.87	$257.04
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $61.66 / $87.10	Professional	26	$61.66	$61.66	$87.10
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $165.96 / $169.82	Professional	TC	$165.96	$165.96	$169.82