Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $72.56 / $297.39	Facility	26	$62.50	$72.56	$297.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $402.08 / $594.00	Professional		$250.00	$402.08	$594.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $93.75 / $141.00	Professional	26	$62.50	$93.75	$141.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $282.87 / $440.00	Professional	TC	$187.50	$282.87	$440.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $138.33 / $138.33 / $138.33	Professional	26	$138.33	$138.33	$138.33
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $379.81 / $379.81 / $379.81	Professional	50	$379.81	$379.81	$379.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.37 / $97.37 / $261.19	Facility	26	$97.37	$97.37	$261.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.34 / $480.06 / $914.26	Professional		$251.34	$480.06	$914.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.44 / $105.76 / $179.70	Professional	26	$60.44	$105.76	$179.70
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $507.23 / $507.23 / $507.23	Professional	50	$507.23	$507.23	$507.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $189.17 / $367.05 / $743.08	Professional	TC	$189.17	$367.05	$743.08
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $95.44 / $95.44 / $95.44	Facility	26	$95.44	$95.44	$95.44
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $291.87 / $453.44 / $609.08	Professional		$291.87	$453.44	$609.08
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $66.81 / $99.33 / $127.94	Professional	26	$66.81	$99.33	$127.94
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $225.06 / $353.66 / $492.35	Professional	TC	$225.06	$353.66	$492.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.00 / $268.59 / $471.90	Professional		$97.00	$268.59	$471.90
United Facility/Professional Professional Modifier Low / Median / High Price $298.64 / $412.28 / $784.59	Professional		$298.64	$412.28	$784.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.04 / $77.76 / $164.61	Professional	26	$66.04	$77.76	$164.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $227.90 / $327.08 / $601.24	Professional	TC	$227.90	$327.08	$601.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $239.14 / $239.14 / $239.14	Professional		$239.14	$239.14	$239.14
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $58.17 / $58.17 / $58.17	Professional	26	$58.17	$58.17	$58.17
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $180.97 / $180.97 / $180.97	Professional	TC	$180.97	$180.97	$180.97