Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $69.98 / $208.86	Facility	26	$62.50	$69.98	$208.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.42 / $372.08 / $688.75	Professional		$207.42	$372.08	$688.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $110.00 / $232.90	Professional	26	$62.50	$110.00	$232.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $954.32 / $954.32 / $1,941.27	Professional	50	$954.32	$954.32	$1,941.27
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $104.19 / $137.50 / $239.48	Professional	52	$104.19	$137.50	$239.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $143.31 / $257.14 / $440.00	Professional	TC	$143.31	$257.14	$440.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $122.63 / $153.88 / $288.56	Professional		$122.63	$153.88	$288.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.15 / $61.09 / $131.40	Professional	26	$47.15	$61.09	$131.40
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $201.99 / $201.99 / $220.74	Professional	50	$201.99	$201.99	$220.74
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $102.36 / $121.45 / $167.32	Professional	TC	$102.36	$121.45	$167.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $198.04	Facility	26	$73.64	$73.64	$198.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.71 / $327.16 / $725.59	Professional		$143.71	$327.16	$725.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.58 / $72.90 / $138.04	Professional	26	$45.58	$72.90	$138.04
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $301.29 / $301.29 / $301.29	Professional	50	$301.29	$301.29	$301.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.42 / $231.94 / $628.33	Professional	TC	$104.42	$231.94	$628.33
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $72.18 / $72.18 / $72.18	Facility	26	$72.18	$72.18	$72.18
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $178.90 / $286.86 / $492.05	Professional		$178.90	$286.86	$492.05
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $45.59 / $71.02 / $96.75	Professional	26	$45.59	$71.02	$96.75
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $126.57 / $202.94 / $423.46	Professional	TC	$126.57	$202.94	$423.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.30 / $135.62 / $256.49	Professional		$61.30	$135.62	$256.49
United Facility/Professional Professional Modifier Low / Median / High Price $179.04 / $268.56 / $606.08	Professional		$179.04	$268.56	$606.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.44 / $57.88 / $124.49	Professional	26	$50.44	$57.88	$124.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.71 / $185.57 / $427.85	Professional	TC	$123.71	$185.57	$427.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $157.16 / $157.16 / $157.16	Professional		$157.16	$157.16	$157.16
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $48.03 / $48.03 / $48.03	Professional	26	$48.03	$48.03	$48.03
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $109.13 / $109.13 / $109.13	Professional	TC	$109.13	$109.13	$109.13