Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $68.75 / $222.26	Facility	26	$62.50	$68.75	$222.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.78 / $375.00 / $630.00	Professional		$231.78	$375.00	$630.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $106.25 / $221.74	Professional	26	$62.50	$106.25	$221.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.74 / $263.83 / $433.00	Professional	TC	$170.74	$263.83	$433.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $133.77 / $167.45 / $218.22	Professional		$133.77	$167.45	$218.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.85 / $64.41 / $130.74	Professional	26	$46.85	$64.41	$130.74
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $112.73 / $112.73 / $160.86	Professional	TC	$112.73	$112.73	$160.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $197.06	Facility	26	$72.95	$72.95	$197.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.66 / $369.35 / $745.00	Professional		$167.66	$369.35	$745.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.36 / $78.68 / $132.18	Professional	26	$45.36	$78.68	$132.18
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $338.09 / $338.09 / $338.09	Professional	50	$338.09	$338.09	$338.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.44 / $280.00 / $607.41	Professional	TC	$125.44	$280.00	$607.41
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $71.81 / $71.81 / $71.81	Facility	26	$71.81	$71.81	$71.81
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $248.17 / $409.25 / $544.34	Professional		$248.17	$409.25	$544.34
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $43.15 / $70.01 / $96.14	Professional	26	$43.15	$70.01	$96.14
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $177.22 / $337.55 / $469.40	Professional	TC	$177.22	$337.55	$469.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.48 / $180.80 / $297.08	Professional		$41.48	$180.80	$297.08
United Facility/Professional Professional Modifier Low / Median / High Price $201.16 / $318.17 / $647.16	Professional		$201.16	$318.17	$647.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.65 / $57.60 / $122.11	Professional	26	$49.65	$57.60	$122.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $146.11 / $247.51 / $540.45	Professional	TC	$146.11	$247.51	$540.45
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $173.25 / $173.25 / $173.25	Professional		$173.25	$173.25	$173.25
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $47.53 / $47.53 / $47.53	Professional	26	$47.53	$47.53	$47.53
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $125.73 / $125.73 / $125.73	Professional	TC	$125.73	$125.73	$125.73