Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.80 / $696.15 / $1,094.11	Facility		$71.80	$696.15	$1,094.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.15 / $13.02 / $53.33	Facility	26	$10.15	$13.02	$53.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.48 / $89.42 / $149.04	Professional		$66.48	$89.42	$149.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.15 / $14.19 / $31.65	Professional	26	$10.15	$14.19	$31.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.34 / $74.65 / $115.53	Professional	TC	$56.34	$74.65	$115.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.47 / $19.98 / $32.17	Professional	26	$8.47	$19.98	$32.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.36 / $328.84 / $637.23	Facility		$71.36	$328.84	$637.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.75 / $17.75 / $48.01	Facility	26	$17.75	$17.75	$48.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.49 / $89.94 / $180.09	Professional		$62.49	$89.94	$180.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.85 / $18.50 / $33.03	Professional	26	$10.85	$18.50	$33.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.24 / $77.36 / $149.37	Professional	TC	$54.24	$77.36	$149.37
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $80.93 / $212.48 / $340.57	Facility		$80.93	$212.48	$340.57
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $17.50 / $17.50 / $17.50	Facility	26	$17.50	$17.50	$17.50
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $64.95 / $88.74 / $123.23	Professional		$64.95	$88.74	$123.23
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $18.16 / $22.97	Professional	26	$10.83	$18.16	$22.97
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $51.61 / $68.95 / $98.15	Professional	TC	$51.61	$68.95	$98.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.77 / $100.33 / $165.35	Professional		$42.77	$100.33	$165.35
United Facility/Professional Facility Modifier Low / Median / High Price $17.18 / $62.72 / $194.10	Facility		$17.18	$62.72	$194.10
United Facility/Professional Professional Modifier Low / Median / High Price $63.66 / $80.00 / $163.86	Professional		$63.66	$80.00	$163.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.42 / $14.08 / $28.96	Professional	26	$12.42	$14.08	$28.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.21 / $66.45 / $134.16	Professional	TC	$51.21	$66.45	$134.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.61 / $48.61 / $48.61	Professional		$48.61	$48.61	$48.61
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.17 / $7.17 / $7.17	Professional	26	$7.17	$7.17	$7.17
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $41.44 / $41.44 / $41.44	Professional	TC	$41.44	$41.44	$41.44