Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.29 / $302.00	Facility	26	$51.29	$51.29	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $467.74 / $1,202.26	Professional		$169.82	$467.74	$1,202.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $120.23 / $363.08	Professional	26	$54.95	$120.23	$363.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $309.03 / $588.84	Professional	TC	$120.23	$309.03	$588.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $309.03 / $645.65	Professional		$269.15	$309.03	$645.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $120.23 / $177.83	Professional	26	$77.62	$120.23	$177.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $251.19 / $251.19	Professional	TC	$251.19	$251.19	$251.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $117.49 / $204.17	Facility	26	$25.70	$117.49	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $457.09 / $912.01	Professional		$245.47	$457.09	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $107.15 / $218.78	Professional	26	$72.44	$107.15	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $338.84 / $741.31	Professional	TC	$186.21	$338.84	$741.31
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $117.49 / $117.49	Facility	26	$117.49	$117.49	$117.49
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $426.58 / $588.84	Professional		$257.04	$426.58	$588.84
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $104.71 / $154.88	Professional	26	$70.79	$104.71	$154.88
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $309.03 / $457.09	Professional	TC	$190.55	$309.03	$457.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $151.36 / $416.87	Professional		$32.36	$151.36	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $436.52 / $776.25	Professional		$309.03	$436.52	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $95.50 / $181.97	Professional	26	$81.28	$95.50	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $338.84 / $602.56	Professional	TC	$223.87	$338.84	$602.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $363.08	Professional		$234.42	$234.42	$363.08
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $63.10 / $102.33	Professional	26	$63.10	$63.10	$102.33
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $173.78 / $269.15	Professional	TC	$173.78	$173.78	$269.15