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 / $224.95	Facility	26	$51.29	$59.00	$224.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $290.20 / $511.03	Professional		$171.00	$290.20	$511.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $66.81 / $140.78	Professional	26	$51.30	$66.81	$140.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $214.05 / $360.22	Professional	TC	$119.70	$214.05	$360.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $156.15 / $195.19 / $378.48	Professional		$156.15	$195.19	$378.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.06 / $67.80 / $136.74	Professional	26	$48.06	$67.80	$136.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.64 / $75.64 / $204.08	Facility	26	$75.64	$75.64	$204.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.15 / $331.47 / $683.43	Professional		$186.15	$331.47	$683.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $74.47 / $140.63	Professional	26	$46.77	$74.47	$140.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.63 / $254.27 / $532.72	Professional	TC	$145.63	$254.27	$532.72
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $74.34 / $74.34 / $74.34	Facility	26	$74.34	$74.34	$74.34
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $192.59 / $317.18 / $449.45	Professional		$192.59	$317.18	$449.45
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $52.04 / $77.12 / $97.57	Professional	26	$52.04	$77.12	$97.57
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $143.91 / $232.99 / $342.86	Professional	TC	$143.91	$232.99	$342.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $169.42 / $307.93	Professional		$62.75	$169.42	$307.93
United Facility/Professional Professional Modifier Low / Median / High Price $205.46 / $311.63 / $566.60	Professional		$205.46	$311.63	$566.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.64 / $60.29 / $122.62	Professional	26	$51.64	$60.29	$122.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.16 / $232.63 / $442.83	Professional	TC	$151.16	$232.63	$442.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $156.57 / $156.57 / $156.57	Professional		$156.57	$156.57	$156.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $38.03 / $38.03 / $38.03	Professional	26	$38.03	$38.03	$38.03
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $118.55 / $118.55 / $118.55	Professional	TC	$118.55	$118.55	$118.55