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 $239.88 / $467.74 / $1,348.96	Professional		$239.88	$467.74	$1,348.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $154.88 / $389.05	Professional	26	$63.10	$154.88	$389.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $363.08 / $851.14	Professional	TC	$186.21	$363.08	$851.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $302.00 / $371.54	Professional		$269.15	$302.00	$371.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $107.15 / $177.83	Professional	26	$75.86	$107.15	$177.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $218.78 / $288.40	Professional	TC	$204.17	$218.78	$288.40
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 $288.40 / $537.03 / $1,288.25	Professional		$288.40	$537.03	$1,288.25
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 $229.09 / $407.38 / $1,096.48	Professional	TC	$229.09	$407.38	$1,096.48
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 $275.42 / $501.19 / $870.96	Professional		$275.42	$501.19	$870.96
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 $199.53 / $380.19 / $776.25	Professional	TC	$199.53	$380.19	$776.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $177.83 / $501.19	Professional		$32.36	$177.83	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $501.19 / $1,071.52	Professional		$346.74	$501.19	$1,071.52
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 $263.03 / $398.11 / $870.96	Professional	TC	$263.03	$398.11	$870.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $295.12 / $371.54	Professional		$295.12	$295.12	$371.54
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 $218.78 / $218.78 / $269.15	Professional	TC	$218.78	$218.78	$269.15