Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $79.43 / $575.44	Facility	26	$51.29	$79.43	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $245.47 / $562.34	Professional		$169.82	$245.47	$562.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $58.88 / $109.65	Professional	26	$51.29	$58.88	$109.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $181.97 / $363.08	Professional	TC	$120.23	$181.97	$363.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $158.49 / $173.78	Professional		$141.25	$158.49	$173.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $69.18 / $100.00	Facility	26	$14.79	$69.18	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $275.42 / $660.69	Professional		$151.36	$275.42	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $61.66 / $112.20	Professional	26	$43.65	$61.66	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $199.53 / $588.84	Professional	TC	$109.65	$199.53	$588.84
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $169.82 / $524.81	Professional		$151.36	$169.82	$524.81
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $45.71 / $83.18	Professional	26	$42.66	$45.71	$83.18
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $123.03 / $457.09	Professional	TC	$107.15	$123.03	$457.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $114.82 / $263.03	Professional		$32.36	$114.82	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $275.42 / $602.56	Professional		$177.83	$275.42	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $54.95 / $97.72	Professional	26	$45.71	$54.95	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $194.98 / $489.78	Professional	TC	$125.89	$194.98	$489.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $213.80	Professional		$194.98	$194.98	$213.80
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $53.70 / $60.26	Professional	26	$53.70	$53.70	$60.26
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $138.04 / $154.88	Professional	TC	$138.04	$138.04	$154.88