Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $109.65 / $870.96	Facility	26	$61.66	$109.65	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $457.09 / $1,122.02	Professional		$251.19	$457.09	$1,122.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $123.03 / $263.03	Professional	26	$63.10	$123.03	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $338.84 / $645.65	Professional	TC	$186.21	$338.84	$645.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $234.42 / $707.95	Professional		$223.87	$234.42	$707.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $112.20 / $138.04	Professional	26	$63.10	$112.20	$138.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $95.50 / $165.96	Facility	26	$20.89	$95.50	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $446.68 / $933.25	Professional		$251.19	$446.68	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $104.71 / $190.55	Professional	26	$60.26	$104.71	$190.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $346.74 / $758.58	Professional	TC	$199.53	$346.74	$758.58
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $95.50	Facility	26	$95.50	$95.50	$95.50
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $436.52 / $602.56	Professional		$239.88	$436.52	$602.56
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $89.13 / $128.82	Professional	26	$58.88	$89.13	$128.82
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $331.13 / $489.78	Professional	TC	$181.97	$331.13	$489.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $162.18 / $436.52	Professional		$32.36	$162.18	$436.52
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $407.38 / $758.58	Professional		$295.12	$407.38	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $77.62 / $154.88	Professional	26	$66.07	$77.62	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $323.59 / $602.56	Professional	TC	$229.09	$323.59	$602.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $323.59	Professional		$263.03	$263.03	$323.59
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $64.57 / $83.18	Professional	26	$64.57	$64.57	$83.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $199.53 / $245.47	Professional	TC	$199.53	$199.53	$245.47