Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.74 / $556.20 / $1,487.40	Facility		$106.74	$556.20	$1,487.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.85 / $32.49 / $126.81	Facility	26	$25.85	$32.49	$126.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.70 / $116.56 / $342.32	Professional		$77.70	$116.56	$342.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.85 / $36.77 / $134.32	Professional	26	$25.85	$36.77	$134.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.86 / $73.70 / $148.21	Professional	TC	$51.86	$73.70	$148.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.98 / $90.60 / $116.87	Professional		$68.98	$90.60	$116.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.15 / $36.45 / $79.78	Professional	26	$28.15	$36.45	$79.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.04 / $60.25 / $74.47	Professional	TC	$51.04	$60.25	$74.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.35 / $210.42 / $330.70	Facility		$94.35	$210.42	$330.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.62 / $43.62 / $117.12	Facility	26	$43.62	$43.62	$117.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.02 / $129.41 / $250.95	Professional		$80.02	$129.41	$250.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.06 / $42.85 / $84.61	Professional	26	$27.06	$42.85	$84.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.97 / $88.09 / $169.67	Professional	TC	$52.97	$88.09	$169.67
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $121.77 / $265.27 / $425.20	Facility		$121.77	$265.27	$425.20
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $42.58 / $42.58 / $42.58	Facility	26	$42.58	$42.58	$42.58
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $75.45 / $120.21 / $166.69	Professional		$75.45	$120.21	$166.69
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $25.84 / $42.58 / $55.88	Professional	26	$25.84	$42.58	$55.88
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $49.62 / $80.01 / $112.40	Professional	TC	$49.62	$80.01	$112.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $88.55 / $177.04	Professional		$37.20	$88.55	$177.04
United Facility/Professional Facility Modifier Low / Median / High Price $252.18 / $252.18 / $567.40	Facility		$252.18	$252.18	$567.40
United Facility/Professional Professional Modifier Low / Median / High Price $94.03 / $110.00 / $198.92	Professional		$94.03	$110.00	$198.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.39 / $34.31 / $62.33	Professional	26	$30.39	$34.31	$62.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.70 / $75.03 / $133.37	Professional	TC	$62.70	$75.03	$133.37
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $73.23 / $73.23 / $73.23	Professional		$73.23	$73.23	$73.23
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.71 / $23.71 / $23.71	Professional	26	$23.71	$23.71	$23.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $49.52 / $49.52 / $49.52	Professional	TC	$49.52	$49.52	$49.52