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 / $337.97	Facility	26	$51.29	$59.00	$337.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $416.50 / $764.17	Professional		$171.00	$416.50	$764.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $103.09 / $266.85	Professional	26	$51.30	$103.09	$266.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $291.06 / $497.09	Professional	TC	$119.70	$291.06	$497.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $229.74 / $273.37 / $807.66	Professional		$229.74	$273.37	$807.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $76.93 / $107.07 / $212.63	Professional	26	$76.93	$107.07	$212.63
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $240.32 / $240.32 / $240.32	Professional	TC	$240.32	$240.32	$240.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.52 / $118.52 / $316.64	Facility	26	$118.52	$118.52	$316.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.52 / $490.82 / $915.38	Professional		$269.52	$490.82	$915.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.48 / $112.04 / $211.36	Professional	26	$73.48	$112.04	$211.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $196.04 / $358.30 / $729.77	Professional	TC	$196.04	$358.30	$729.77
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $116.46 / $116.46 / $116.46	Facility	26	$116.46	$116.46	$116.46
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $283.42 / $445.10 / $597.61	Professional		$283.42	$445.10	$597.61
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $80.89 / $115.56 / $152.86	Professional	26	$80.89	$115.56	$152.86
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $205.82 / $337.88 / $464.48	Professional	TC	$205.82	$337.88	$464.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $265.75 / $484.63	Professional		$95.09	$265.75	$484.63
United Facility/Professional Professional Modifier Low / Median / High Price $304.58 / $434.36 / $792.96	Professional		$304.58	$434.36	$792.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.12 / $95.10 / $191.16	Professional	26	$81.12	$95.10	$191.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $221.41 / $336.90 / $608.26	Professional	TC	$221.41	$336.90	$608.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $213.69 / $213.69 / $213.69	Professional		$213.69	$213.69	$213.69
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $56.02 / $56.02 / $56.02	Professional	26	$56.02	$56.02	$56.02
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $157.66 / $157.66 / $157.66	Professional	TC	$157.66	$157.66	$157.66