Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $147.90 / $4,512.99	Facility	26	$51.29	$147.90	$4,512.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $205.57 / $371.00	Professional		$171.00	$205.57	$371.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $85.15 / $237.72	Professional	26	$51.30	$85.15	$237.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $103.05 / $120.64 / $220.00	Professional	TC	$103.05	$120.64	$220.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.03 / $144.54 / $286.92	Professional		$112.03	$144.54	$286.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.38 / $83.02 / $169.44	Professional	26	$60.38	$83.02	$169.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $81.70 / $89.10 / $112.42	Professional	TC	$81.70	$89.10	$112.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.15 / $94.15 / $253.12	Facility	26	$94.15	$94.15	$253.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.96 / $245.56 / $436.51	Professional		$136.96	$245.56	$436.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.76 / $95.10 / $179.10	Professional	26	$58.76	$95.10	$179.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.63 / $137.75 / $257.55	Professional	TC	$75.63	$137.75	$257.55
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $92.57 / $92.57 / $92.57	Facility	26	$92.57	$92.57	$92.57
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $146.80 / $217.58 / $275.26	Professional		$146.80	$217.58	$275.26
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $64.80 / $91.41 / $121.50	Professional	26	$64.80	$91.41	$121.50
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $82.01 / $124.47 / $154.53	Professional	TC	$82.01	$124.47	$154.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.38 / $125.08 / $247.12	Professional		$78.38	$125.08	$247.12
United Facility/Professional Professional Modifier Low / Median / High Price $153.44 / $186.26 / $352.35	Professional		$153.44	$186.26	$352.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.98 / $76.12 / $155.11	Professional	26	$64.98	$76.12	$155.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.44 / $110.20 / $202.73	Professional	TC	$86.44	$110.20	$202.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $119.55 / $119.55 / $119.55	Professional		$119.55	$119.55	$119.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $51.81 / $51.81 / $51.81	Professional	26	$51.81	$51.81	$51.81
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $67.73 / $67.73 / $67.73	Professional	TC	$67.73	$67.73	$67.73