Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.30 / $97.02 / $395.80	Facility	26	$51.30	$97.02	$395.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $233.54 / $342.39	Professional		$171.00	$233.54	$342.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $101.34 / $160.44	Professional	26	$51.30	$101.34	$160.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.51 / $119.70 / $220.00	Professional	TC	$100.51	$119.70	$220.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.97 / $326.14 / $473.54	Professional		$309.97	$326.14	$473.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $86.52 / $180.71 / $180.71	Professional	26	$86.52	$180.71	$180.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.66 / $129.66 / $349.14	Facility	26	$129.66	$129.66	$349.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.00 / $475.66 / $928.37	Professional		$244.00	$475.66	$928.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.20 / $116.14 / $232.16	Professional	26	$73.20	$116.14	$232.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $170.80 / $352.17 / $681.61	Professional	TC	$170.80	$352.17	$681.61
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $127.93 / $127.93 / $127.93	Facility	26	$127.93	$127.93	$127.93
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $309.97 / $473.92 / $663.48	Professional		$309.97	$473.92	$663.48
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $86.63 / $124.73 / $167.91	Professional	26	$86.63	$124.73	$167.91
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $224.05 / $353.99 / $495.58	Professional	TC	$224.05	$353.99	$495.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $74.94 / $123.08 / $242.21	Professional		$74.94	$123.08	$242.21
United Facility/Professional Professional Modifier Low / Median / High Price $325.48 / $407.85 / $835.94	Professional		$325.48	$407.85	$835.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $86.47 / $103.90 / $213.36	Professional	26	$86.47	$103.90	$213.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.84 / $307.86 / $603.86	Professional	TC	$234.84	$307.86	$603.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $184.69 / $184.69 / $184.69	Professional		$184.69	$184.69	$184.69
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $93.86 / $93.86 / $93.86	Professional	26	$93.86	$93.86	$93.86
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $90.83 / $90.83 / $90.83	Professional	TC	$90.83	$90.83	$90.83