Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.59 / $58.18 / $247.40	Facility	26	$50.59	$58.18	$247.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.60 / $228.49 / $475.00	Professional		$155.60	$228.49	$475.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.59 / $73.22 / $140.00	Professional	26	$50.59	$73.22	$140.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $105.01 / $151.12 / $335.00	Professional	TC	$105.01	$151.12	$335.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $132.38 / $156.66 / $465.39	Professional		$132.38	$156.66	$465.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.71 / $98.39 / $121.16	Professional	26	$41.71	$98.39	$121.16
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $383.23 / $383.23 / $383.23	Professional	TC	$383.23	$383.23	$383.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.45 / $86.45 / $86.45	Facility	26	$86.45	$86.45	$86.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.09 / $291.61 / $534.52	Professional		$160.09	$291.61	$534.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.64 / $87.28 / $160.35	Professional	26	$53.64	$87.28	$160.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $105.67 / $197.26 / $362.12	Professional	TC	$105.67	$197.26	$362.12
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $85.01 / $85.01 / $85.01	Facility	26	$85.01	$85.01	$85.01
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $185.57 / $265.10 / $369.49	Professional		$185.57	$265.10	$369.49
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $59.51 / $86.82 / $113.95	Professional	26	$59.51	$86.82	$113.95
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $126.06 / $180.09 / $251.00	Professional	TC	$126.06	$180.09	$251.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $91.39 / $151.63 / $291.62	Professional		$91.39	$151.63	$291.62
United Facility/Professional Professional Modifier Low / Median / High Price $197.04 / $420.30 / $1,079.64	Professional		$197.04	$420.30	$1,079.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.83 / $68.23 / $144.18	Professional	26	$58.83	$68.23	$144.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.50 / $333.09 / $997.85	Professional	TC	$131.50	$333.09	$997.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $167.56 / $167.56 / $167.56	Professional		$167.56	$167.56	$167.56
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $55.61 / $55.61 / $55.61	Professional	26	$55.61	$55.61	$55.61
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $111.96 / $111.96 / $111.96	Professional	TC	$111.96	$111.96	$111.96