Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $89.13 / $851.14	Facility	26	$51.29	$89.13	$851.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $363.08 / $1,174.90	Professional		$169.82	$363.08	$1,174.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $93.33 / $316.23	Professional	26	$66.07	$93.33	$316.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $257.04 / $562.34	Professional	TC	$120.23	$257.04	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $245.47 / $467.74	Professional		$199.53	$245.47	$467.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $89.13 / $144.54	Professional	26	$64.57	$89.13	$144.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $173.78 / $323.59	Professional	TC	$158.49	$173.78	$323.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.38 / $97.72 / $169.82	Facility	26	$21.38	$97.72	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $338.84 / $676.08	Professional		$199.53	$338.84	$676.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $87.10 / $181.97	Professional	26	$60.26	$87.10	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $229.09 / $501.19	Professional	TC	$141.25	$229.09	$501.19
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Facility	26	$95.50	$95.50	$95.50
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $302.00 / $436.52	Professional		$204.17	$302.00	$436.52
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $85.11 / $128.82	Professional	26	$58.88	$85.11	$128.82
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $213.80 / $309.03	Professional	TC	$144.54	$213.80	$309.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $128.82 / $354.81	Professional		$32.36	$128.82	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $288.40 / $549.54	Professional		$245.47	$288.40	$549.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $79.43 / $154.88	Professional	26	$67.61	$79.43	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $213.80 / $389.05	Professional	TC	$169.82	$213.80	$389.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $204.17 / $288.40	Professional		$204.17	$204.17	$288.40
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $57.54 / $83.18	Professional	26	$57.54	$57.54	$83.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $147.91 / $208.93	Professional	TC	$147.91	$147.91	$208.93