Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $65.09 / $270.77	Facility	26	$62.50	$65.09	$270.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $402.08 / $606.74	Professional		$250.00	$402.08	$606.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $107.53 / $202.50	Professional	26	$62.50	$107.53	$202.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $299.00 / $460.54	Professional	TC	$187.50	$299.00	$460.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $187.97 / $205.59 / $247.42	Professional		$187.97	$205.59	$247.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.44 / $110.96 / $164.45	Professional	26	$42.44	$110.96	$164.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.95 / $87.95 / $236.62	Facility	26	$87.95	$87.95	$236.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.16 / $446.02 / $891.16	Professional		$235.16	$446.02	$891.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.56 / $95.09 / $159.03	Professional	26	$54.56	$95.09	$159.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.06 / $352.04 / $735.48	Professional	TC	$179.06	$352.04	$735.48
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $86.16 / $86.16 / $86.16	Facility	26	$86.16	$86.16	$86.16
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $277.17 / $439.34 / $627.44	Professional		$277.17	$439.34	$627.44
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $54.60 / $84.01 / $115.50	Professional	26	$54.60	$84.01	$115.50
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $216.85 / $360.13 / $527.78	Professional	TC	$216.85	$360.13	$527.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $237.27 / $434.42	Professional		$95.09	$237.27	$434.42
United Facility/Professional Professional Modifier Low / Median / High Price $285.54 / $402.46 / $748.50	Professional		$285.54	$402.46	$748.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.30 / $69.90 / $147.86	Professional	26	$60.30	$69.90	$147.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.48 / $316.63 / $648.27	Professional	TC	$218.48	$316.63	$648.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $226.46 / $226.46 / $226.46	Professional		$226.46	$226.46	$226.46
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $53.34 / $53.34 / $53.34	Professional	26	$53.34	$53.34	$53.34
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $173.12 / $173.12 / $173.12	Professional	TC	$173.12	$173.12	$173.12