Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $59.00 / $210.73	Facility	26	$51.29	$59.00	$210.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $275.00 / $458.85	Professional		$171.00	$275.00	$458.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $60.71 / $136.24	Professional	26	$51.30	$60.71	$136.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $209.38 / $309.89	Professional	TC	$119.70	$209.38	$309.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.51 / $162.96 / $488.88	Professional		$138.51	$162.96	$488.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.59 / $69.48 / $109.82	Professional	26	$44.59	$69.48	$109.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $184.61	Facility	26	$69.05	$69.05	$184.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.12 / $287.91 / $567.00	Professional		$166.12	$287.91	$567.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.79 / $67.47 / $127.99	Professional	26	$42.79	$67.47	$127.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.41 / $212.41 / $449.92	Professional	TC	$128.41	$212.41	$449.92
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $67.58 / $67.58 / $67.58	Facility	26	$67.58	$67.58	$67.58
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $171.52 / $270.27 / $371.30	Professional		$171.52	$270.27	$371.30
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $47.31 / $70.12 / $88.70	Professional	26	$47.31	$70.12	$88.70
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $123.97 / $201.59 / $276.58	Professional	TC	$123.97	$201.59	$276.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.81 / $191.04 / $325.84	Professional		$38.81	$191.04	$325.84
United Facility/Professional Professional Modifier Low / Median / High Price $180.73 / $251.18 / $489.09	Professional		$180.73	$251.18	$489.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.36 / $55.38 / $119.39	Professional	26	$47.36	$55.38	$119.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.22 / $191.41 / $366.61	Professional	TC	$131.22	$191.41	$366.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $137.61 / $137.61 / $137.61	Professional		$137.61	$137.61	$137.61
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $34.31 / $34.31 / $34.31	Professional	26	$34.31	$34.31	$34.31
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $103.30 / $103.30 / $103.30	Professional	TC	$103.30	$103.30	$103.30