Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $108.90 / $352.39	Facility	26	$62.50	$108.90	$352.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $425.00 / $750.25	Professional		$250.00	$425.00	$750.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $124.59 / $290.01	Professional	26	$62.50	$124.59	$290.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $299.00 / $494.98	Professional	TC	$187.50	$299.00	$494.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $202.97 / $253.67 / $521.87	Professional		$202.97	$253.67	$521.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.22 / $105.12 / $207.29	Professional	26	$75.22	$105.12	$207.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.17 / $116.17 / $311.17	Facility	26	$116.17	$116.17	$311.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.79 / $567.65 / $1,255.21	Professional		$240.79	$567.65	$1,255.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.18 / $114.55 / $215.91	Professional	26	$72.18	$114.55	$215.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.45 / $439.99 / $1,116.65	Professional	TC	$179.45	$439.99	$1,116.65
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $114.04 / $114.04 / $114.04	Facility	26	$114.04	$114.04	$114.04
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $358.64 / $573.83 / $912.91	Professional		$358.64	$573.83	$912.91
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $73.61 / $111.19 / $152.87	Professional	26	$73.61	$111.19	$152.87
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $261.74 / $448.38 / $753.88	Professional	TC	$261.74	$448.38	$753.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $237.27 / $439.78	Professional		$95.09	$237.27	$439.78
United Facility/Professional Professional Modifier Low / Median / High Price $304.67 / $461.58 / $1,105.28	Professional		$304.67	$461.58	$1,105.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.81 / $90.26 / $196.38	Professional	26	$78.81	$90.26	$196.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.39 / $347.08 / $899.93	Professional	TC	$217.39	$347.08	$899.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $253.86 / $253.86 / $253.86	Professional		$253.86	$253.86	$253.86
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $73.47 / $73.47 / $73.47	Professional	26	$73.47	$73.47	$73.47
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $180.39 / $180.39 / $180.39	Professional	TC	$180.39	$180.39	$180.39