Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $105.21 / $309.07	Facility	26	$51.29	$105.21	$309.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $370.55 / $687.99	Professional		$171.00	$370.55	$687.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $96.44 / $272.74	Professional	26	$51.30	$96.44	$272.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $277.70 / $405.40	Professional	TC	$119.70	$277.70	$405.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.15 / $255.19 / $522.86	Professional		$204.15	$255.19	$522.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.69 / $97.81 / $194.45	Professional	26	$69.69	$97.81	$194.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $211.66 / $211.66 / $385.94	Professional	TC	$211.66	$211.66	$385.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.46 / $108.46 / $290.70	Facility	26	$108.46	$108.46	$290.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.01 / $427.67 / $789.65	Professional		$242.01	$427.67	$789.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.18 / $102.34 / $201.75	Professional	26	$67.18	$102.34	$201.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $174.83 / $302.83 / $597.85	Professional	TC	$174.83	$302.83	$597.85
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $106.55 / $106.55 / $106.55	Facility	26	$106.55	$106.55	$106.55
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $257.33 / $395.18 / $503.16	Professional		$257.33	$395.18	$503.16
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $74.59 / $105.22 / $139.85	Professional	26	$74.59	$105.22	$139.85
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $182.73 / $280.63 / $365.47	Professional	TC	$182.73	$280.63	$365.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $235.47 / $433.61	Professional		$95.09	$235.47	$433.61
United Facility/Professional Professional Modifier Low / Median / High Price $276.47 / $358.10 / $673.68	Professional		$276.47	$358.10	$673.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.18 / $88.40 / $180.77	Professional	26	$75.18	$88.40	$180.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $195.37 / $265.20 / $504.50	Professional	TC	$195.37	$265.20	$504.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $208.16 / $208.16 / $208.16	Professional		$208.16	$208.16	$208.16
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $55.81 / $55.81 / $55.81	Professional	26	$55.81	$55.81	$55.81
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $152.35 / $152.35 / $152.35	Professional	TC	$152.35	$152.35	$152.35