Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $96.07 / $389.25	Facility	26	$51.29	$96.07	$389.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $327.69 / $571.22	Professional		$171.00	$327.69	$571.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $111.36 / $259.01	Professional	26	$51.30	$111.36	$259.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $213.72 / $320.13	Professional	TC	$119.70	$213.72	$320.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $196.21 / $245.26 / $502.52	Professional		$196.21	$245.26	$502.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $85.79 / $156.72 / $228.97	Professional	26	$85.79	$156.72	$228.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $157.93 / $167.89 / $167.89	Professional	TC	$157.93	$167.89	$167.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.94 / $128.94 / $342.37	Facility	26	$128.94	$128.94	$342.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.00 / $454.23 / $876.02	Professional		$235.00	$454.23	$876.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.16 / $118.73 / $234.82	Professional	26	$77.16	$118.73	$234.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $156.47 / $320.16 / $661.62	Professional	TC	$156.47	$320.16	$661.62
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $125.21 / $125.21 / $125.21	Facility	26	$125.21	$125.21	$125.21
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $301.01 / $474.39 / $684.11	Professional		$301.01	$474.39	$684.11
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $87.65 / $125.47 / $173.48	Professional	26	$87.65	$125.47	$173.48
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $218.84 / $343.89 / $512.69	Professional	TC	$218.84	$343.89	$512.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.12 / $209.28 / $388.45	Professional		$95.12	$209.28	$388.45
United Facility/Professional Professional Modifier Low / Median / High Price $281.98 / $402.15 / $839.55	Professional		$281.98	$402.15	$839.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.73 / $99.97 / $205.79	Professional	26	$84.73	$99.97	$205.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $185.57 / $270.48 / $609.86	Professional	TC	$185.57	$270.48	$609.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $218.97 / $218.97 / $218.97	Professional		$218.97	$218.97	$218.97
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $73.87 / $73.87 / $73.87	Professional	26	$73.87	$73.87	$73.87
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $145.09 / $145.09 / $145.09	Professional	TC	$145.09	$145.09	$145.09