Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $104.71 / $831.76	Facility	26	$61.66	$104.71	$831.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $426.58 / $776.25	Professional		$251.19	$426.58	$776.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $109.65 / $204.17	Professional	26	$63.10	$109.65	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $302.00 / $562.34	Professional	TC	$186.21	$302.00	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $234.42 / $288.40	Professional		$177.83	$234.42	$288.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $85.11 / $131.83	Professional	26	$61.66	$85.11	$131.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $93.33 / $158.49	Facility	26	$19.95	$93.33	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $446.68 / $954.99	Professional		$229.09	$446.68	$954.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $100.00 / $173.78	Professional	26	$58.88	$100.00	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $331.13 / $758.58	Professional	TC	$181.97	$331.13	$758.58
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $91.20 / $91.20	Facility	26	$91.20	$91.20	$91.20
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $457.09 / $676.08	Professional		$213.80	$457.09	$676.08
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $81.28 / $125.89	Professional	26	$56.23	$81.28	$125.89
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $371.54 / $562.34	Professional	TC	$158.49	$371.54	$562.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $141.25 / $389.05	Professional		$32.36	$141.25	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $426.58 / $776.25	Professional		$275.42	$426.58	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $75.86 / $151.36	Professional	26	$64.57	$75.86	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $323.59 / $630.96	Professional	TC	$204.17	$323.59	$630.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $288.40	Professional		$234.42	$234.42	$288.40
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $61.66 / $79.43	Professional	26	$61.66	$61.66	$79.43
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $173.78 / $213.80	Professional	TC	$173.78	$173.78	$213.80