Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $75.92 / $310.02	Facility	26	$51.29	$75.92	$310.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $298.38 / $480.94	Professional		$171.00	$298.38	$480.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $87.48 / $178.08	Professional	26	$51.30	$87.48	$178.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $213.56 / $361.24	Professional	TC	$119.70	$213.56	$361.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.81 / $177.81 / $177.81	Professional		$177.81	$177.81	$177.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.72 / $126.66 / $187.78	Professional	26	$67.72	$126.66	$187.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.96 / $101.96 / $274.64	Facility	26	$101.96	$101.96	$274.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.16 / $438.74 / $850.26	Professional		$229.16	$438.74	$850.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.23 / $101.09 / $188.97	Professional	26	$63.23	$101.09	$188.97
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $458.57 / $458.57 / $458.57	Professional	50	$458.57	$458.57	$458.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.81 / $330.22 / $665.81	Professional	TC	$173.81	$330.22	$665.81
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $100.40 / $100.40 / $100.40	Facility	26	$100.40	$100.40	$100.40
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $259.11 / $389.22 / $518.21	Professional		$259.11	$389.22	$518.21
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $60.39 / $97.89 / $131.78	Professional	26	$60.39	$97.89	$131.78
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $188.83 / $289.98 / $377.65	Professional	TC	$188.83	$289.98	$377.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.85 / $182.81 / $341.44	Professional		$94.85	$182.81	$341.44
United Facility/Professional Professional Modifier Low / Median / High Price $274.66 / $370.15 / $716.82	Professional		$274.66	$370.15	$716.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.16 / $81.58 / $165.04	Professional	26	$70.16	$81.58	$165.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $198.56 / $282.80 / $530.83	Professional	TC	$198.56	$282.80	$530.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $204.97 / $204.97 / $204.97	Professional		$204.97	$204.97	$204.97
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $54.44 / $54.44 / $54.44	Professional	26	$54.44	$54.44	$54.44
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $150.53 / $150.53 / $150.53	Professional	TC	$150.53	$150.53	$150.53