Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $88.77 / $354.00	Facility	26	$62.50	$88.77	$354.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $429.53 / $1,020.07	Professional		$250.00	$429.53	$1,020.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $127.10 / $330.06	Professional	26	$62.50	$127.10	$330.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $299.00 / $503.60	Professional	TC	$187.50	$299.00	$503.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.41 / $255.52 / $523.53	Professional		$204.41	$255.52	$523.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.51 / $136.19 / $218.01	Professional	26	$77.51	$136.19	$218.01
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $275.63 / $603.66 / $603.66	Professional	TC	$275.63	$603.66	$603.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.86 / $118.86 / $319.62	Facility	26	$118.86	$118.86	$319.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $254.38 / $535.00 / $1,256.69	Professional		$254.38	$535.00	$1,256.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.59 / $126.00 / $210.25	Professional	26	$73.59	$126.00	$210.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $184.41 / $396.90 / $1,097.93	Professional	TC	$184.41	$396.90	$1,097.93
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $120.08 / $120.08 / $120.08	Facility	26	$120.08	$120.08	$120.08
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $361.79 / $611.75 / $1,022.55	Professional		$361.79	$611.75	$1,022.55
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $74.98 / $117.08 / $160.91	Professional	26	$74.98	$117.08	$160.91
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $260.83 / $472.16 / $844.34	Professional	TC	$260.83	$472.16	$844.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $237.27 / $439.20	Professional		$95.09	$237.27	$439.20
United Facility/Professional Professional Modifier Low / Median / High Price $305.57 / $476.82 / $1,112.28	Professional		$305.57	$476.82	$1,112.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.02 / $95.29 / $196.40	Professional	26	$82.02	$95.29	$196.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $216.30 / $356.02 / $918.68	Professional	TC	$216.30	$356.02	$918.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $255.06 / $255.06 / $255.06	Professional		$255.06	$255.06	$255.06
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $75.31 / $75.31 / $75.31	Professional	26	$75.31	$75.31	$75.31
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $179.74 / $179.74 / $179.74	Professional	TC	$179.74	$179.74	$179.74