Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.30 / $69.33 / $286.50	Facility	26	$51.30	$69.33	$286.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $264.62 / $426.88	Professional		$171.00	$264.62	$426.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $78.87 / $136.13	Professional	26	$51.30	$78.87	$136.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $180.09 / $277.83	Professional	TC	$119.70	$180.09	$277.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.83 / $106.35 / $130.91	Professional	26	$60.83	$106.35	$130.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.84 / $93.84 / $251.74	Facility	26	$93.84	$93.84	$251.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.96 / $306.70 / $552.99	Professional		$168.96	$306.70	$552.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.09 / $91.97 / $176.97	Professional	26	$58.09	$91.97	$176.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.31 / $205.03 / $381.36	Professional	TC	$109.31	$205.03	$381.36
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $91.56 / $91.56 / $91.56	Facility	26	$91.56	$91.56	$91.56
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $197.25 / $292.23 / $387.30	Professional		$197.25	$292.23	$387.30
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $62.95 / $91.45 / $120.17	Professional	26	$62.95	$91.45	$120.17
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $137.34 / $198.54 / $267.13	Professional	TC	$137.34	$198.54	$267.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $151.63 / $291.15	Professional		$91.54	$151.63	$291.15
United Facility/Professional Professional Modifier Low / Median / High Price $195.49 / $244.88 / $463.64	Professional		$195.49	$244.88	$463.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.38 / $74.77 / $153.86	Professional	26	$62.38	$74.77	$153.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $124.53 / $164.95 / $306.17	Professional	TC	$124.53	$164.95	$306.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $160.85 / $160.85 / $160.85	Professional		$160.85	$160.85	$160.85
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $55.84 / $55.84 / $55.84	Professional	26	$55.84	$55.84	$55.84
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $105.01 / $105.01 / $105.01	Professional	TC	$105.01	$105.01	$105.01