Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.21 / $439.68 / $830.79	Facility		$97.21	$439.68	$830.79
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.48 / $22.03 / $87.25	Facility	26	$18.48	$22.03	$87.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.17 / $108.72 / $276.30	Professional		$74.17	$108.72	$276.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $26.36 / $70.20	Professional	26	$18.48	$26.36	$70.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.09 / $46.89 / $63.23	Professional	52	$37.09	$46.89	$63.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.70 / $79.36 / $155.47	Professional	TC	$55.70	$79.36	$155.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.95 / $85.74 / $166.65	Professional		$65.95	$85.74	$166.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.78 / $24.89 / $49.23	Professional	26	$19.78	$24.89	$49.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $59.29 / $64.39 / $89.46	Professional	TC	$59.29	$64.39	$89.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.40 / $228.61 / $330.70	Facility		$123.40	$228.61	$330.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.47 / $30.47 / $81.56	Facility	26	$30.47	$30.47	$81.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.09 / $107.31 / $221.44	Professional		$76.09	$107.31	$221.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.34 / $29.87 / $58.08	Professional	26	$19.34	$29.87	$58.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.76 / $82.48 / $171.33	Professional	TC	$56.76	$82.48	$171.33
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $97.75 / $191.24 / $306.52	Facility		$97.75	$191.24	$306.52
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $29.68 / $29.68 / $29.68	Facility	26	$29.68	$29.68	$29.68
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $71.17 / $106.68 / $153.91	Professional		$71.17	$106.68	$153.91
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $18.14 / $28.94 / $39.33	Professional	26	$18.14	$28.94	$39.33
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $53.02 / $77.25 / $119.91	Professional	TC	$53.02	$77.25	$119.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.47 / $87.20 / $177.73	Professional		$36.47	$87.20	$177.73
United Facility/Professional Facility Modifier Low / Median / High Price $28.75 / $68.09 / $252.18	Facility		$28.75	$68.09	$252.18
United Facility/Professional Professional Modifier Low / Median / High Price $81.34 / $95.83 / $176.70	Professional		$81.34	$95.83	$176.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.99 / $23.85 / $43.31	Professional	26	$20.99	$23.85	$43.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.19 / $71.98 / $137.13	Professional	TC	$61.19	$71.98	$137.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.68 / $69.68 / $69.68	Professional		$69.68	$69.68	$69.68
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $16.63 / $16.63 / $16.63	Professional	26	$16.63	$16.63	$16.63
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $53.05 / $53.05 / $53.05	Professional	TC	$53.05	$53.05	$53.05