Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $76.72 / $946.00	Facility	26	$51.29	$76.72	$946.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $313.38 / $563.79	Professional		$171.00	$313.38	$563.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $91.94 / $360.00	Professional	26	$51.30	$91.94	$360.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $230.22 / $387.82	Professional	TC	$119.70	$230.22	$387.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $182.40 / $229.33 / $467.16	Professional		$182.40	$229.33	$467.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.64 / $88.96 / $177.52	Professional	26	$63.64	$88.96	$177.52
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $171.77 / $187.53 / $395.68	Professional	TC	$171.77	$187.53	$395.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.40 / $98.40 / $265.13	Facility	26	$98.40	$98.40	$265.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.08 / $351.17 / $668.77	Professional		$213.08	$351.17	$668.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.73 / $92.07 / $182.60	Professional	26	$60.73	$92.07	$182.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.99 / $253.19 / $498.96	Professional	TC	$154.99	$253.19	$498.96
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $96.54 / $96.54 / $96.54	Facility	26	$96.54	$96.54	$96.54
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $226.53 / $339.80 / $424.75	Professional		$226.53	$339.80	$424.75
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $67.58 / $95.34 / $126.71	Professional	26	$67.58	$95.34	$126.71
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $160.41 / $241.59 / $299.44	Professional	TC	$160.41	$241.59	$299.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $230.51 / $411.18	Professional		$95.09	$230.51	$411.18
United Facility/Professional Professional Modifier Low / Median / High Price $243.81 / $290.48 / $580.58	Professional		$243.81	$290.48	$580.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.73 / $79.69 / $162.08	Professional	26	$68.73	$79.69	$162.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.76 / $211.44 / $414.20	Professional	TC	$169.76	$211.44	$414.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $185.01 / $185.01 / $185.01	Professional		$185.01	$185.01	$185.01
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $50.51 / $50.51 / $50.51	Professional	26	$50.51	$50.51	$50.51
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $134.50 / $134.50 / $134.50	Professional	TC	$134.50	$134.50	$134.50