Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $74.13 / $251.19	Facility	26	$61.66	$74.13	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $389.05 / $977.24	Professional		$208.93	$389.05	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $114.82 / $257.04	Professional	26	$63.10	$114.82	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $251.19 / $512.86	Professional	TC	$134.90	$251.19	$512.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $154.88 / $208.93	Professional		$128.82	$154.88	$208.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $79.43 / $120.23	Professional	26	$51.29	$79.43	$120.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $77.62 / $134.90	Facility	26	$16.98	$77.62	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $331.13 / $707.95	Professional		$147.91	$331.13	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $85.11 / $147.91	Professional	26	$48.98	$85.11	$147.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $239.88 / $562.34	Professional	TC	$104.71	$239.88	$562.34
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Facility	26	$77.62	$77.62	$77.62
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $338.84 / $512.86	Professional		$138.04	$338.84	$512.86
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $67.61 / $104.71	Professional	26	$46.77	$67.61	$104.71
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $257.04 / $426.58	Professional	TC	$91.20	$257.04	$426.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $97.72 / $239.88	Professional		$32.36	$97.72	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $288.40 / $575.44	Professional		$177.83	$288.40	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $63.10 / $125.89	Professional	26	$53.70	$63.10	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $208.93 / $446.68	Professional	TC	$117.49	$208.93	$446.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $190.55	Professional		$151.36	$151.36	$190.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $52.48 / $66.07	Professional	26	$52.48	$52.48	$66.07
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $100.00 / $123.03	Professional	TC	$100.00	$100.00	$123.03