Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $60.26 / $229.09	Facility	26	$51.29	$60.26	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $302.00 / $954.99	Professional		$169.82	$302.00	$954.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $81.28 / $204.17	Professional	26	$51.29	$81.28	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $218.78 / $436.52	Professional	TC	$120.23	$218.78	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $208.93 / $309.03	Professional		$162.18	$208.93	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $67.61 / $112.20	Professional	26	$48.98	$67.61	$112.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $144.54 / $331.13	Professional	TC	$144.54	$144.54	$331.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.22 / $75.86 / $128.82	Facility	26	$16.22	$75.86	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $316.23 / $707.95	Professional		$190.55	$316.23	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $72.44 / $141.25	Professional	26	$46.77	$72.44	$141.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $251.19 / $575.44	Professional	TC	$147.91	$251.19	$575.44
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Facility	26	$74.13	$74.13	$74.13
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $295.12 / $426.58	Professional		$177.83	$295.12	$426.58
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $67.61 / $97.72	Professional	26	$45.71	$67.61	$97.72
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $213.80 / $338.84	Professional	TC	$138.04	$213.80	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $107.15 / $302.00	Professional		$32.36	$107.15	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $309.03 / $549.54	Professional		$204.17	$309.03	$549.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $61.66 / $117.49	Professional	26	$52.48	$61.66	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $234.42 / $426.58	Professional	TC	$154.88	$234.42	$426.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $234.42	Professional		$173.78	$173.78	$234.42
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $42.66 / $64.57	Professional	26	$42.66	$42.66	$64.57
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $128.82 / $173.78	Professional	TC	$128.82	$128.82	$173.78