Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $109.65 / $371.54	Facility	26	$61.66	$109.65	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $426.58 / $1,174.90	Professional		$213.80	$426.58	$1,174.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $162.18 / $457.09	Professional	26	$67.61	$162.18	$457.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $338.84 / $724.44	Professional	TC	$186.21	$338.84	$724.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $269.15 / $562.34	Professional		$223.87	$269.15	$562.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $107.15 / $169.82	Professional	26	$75.86	$107.15	$169.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $173.78 / $346.74	Professional	TC	$173.78	$173.78	$346.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $117.49 / $199.53	Facility	26	$25.12	$117.49	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $501.19 / $1,202.26	Professional		$251.19	$501.19	$1,202.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $125.89 / $213.80	Professional	26	$72.44	$125.89	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $371.54 / $1,047.13	Professional	TC	$194.98	$371.54	$1,047.13
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $114.82 / $114.82	Facility	26	$114.82	$114.82	$114.82
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $501.19 / $851.14	Professional		$239.88	$501.19	$851.14
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $100.00 / $154.88	Professional	26	$70.79	$100.00	$154.88
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $398.11 / $724.44	Professional	TC	$165.96	$398.11	$724.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $162.18 / $426.58	Professional		$32.36	$162.18	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $478.63 / $1,047.13	Professional		$302.00	$478.63	$1,047.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $93.33 / $186.21	Professional	26	$79.43	$93.33	$186.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $354.81 / $891.25	Professional	TC	$218.78	$354.81	$891.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $323.59	Professional		$263.03	$263.03	$323.59
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $77.62 / $100.00	Professional	26	$77.62	$77.62	$100.00
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $181.97 / $223.87	Professional	TC	$181.97	$181.97	$223.87