Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.30 / $95.42 / $390.31	Facility	26	$51.30	$95.42	$390.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $317.02 / $510.93	Professional		$171.00	$317.02	$510.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $110.81 / $252.28	Professional	26	$51.30	$110.81	$252.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $213.60 / $361.28	Professional	TC	$119.70	$213.60	$361.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $193.20 / $287.04 / $328.62	Professional		$193.20	$287.04	$328.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.39 / $122.52 / $229.60	Professional	26	$83.39	$122.52	$229.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $250.48 / $250.48 / $250.48	Professional	TC	$250.48	$250.48	$250.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.28 / $128.28 / $344.21	Facility	26	$128.28	$128.28	$344.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.97 / $479.14 / $1,034.00	Professional		$255.97	$479.14	$1,034.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.69 / $118.45 / $228.72	Professional	26	$77.69	$118.45	$228.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $192.50 / $364.09 / $810.99	Professional	TC	$192.50	$364.09	$810.99
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $126.47 / $126.47 / $126.47	Facility	26	$126.47	$126.47	$126.47
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $288.32 / $437.45 / $566.35	Professional		$288.32	$437.45	$566.35
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $80.41 / $123.31 / $165.99	Professional	26	$80.41	$123.31	$165.99
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $203.41 / $306.52 / $412.78	Professional	TC	$203.41	$306.52	$412.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $185.28 / $345.02	Professional		$95.09	$185.28	$345.02
United Facility/Professional Professional Modifier Low / Median / High Price $310.83 / $450.76 / $859.00	Professional		$310.83	$450.76	$859.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.47 / $102.55 / $213.47	Professional	26	$87.47	$102.55	$213.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $215.13 / $329.86 / $653.22	Professional	TC	$215.13	$329.86	$653.22
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $219.47 / $219.47 / $219.47	Professional		$219.47	$219.47	$219.47
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $57.65 / $57.65 / $57.65	Professional	26	$57.65	$57.65	$57.65
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $161.83 / $161.83 / $161.83	Professional	TC	$161.83	$161.83	$161.83