Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.42 / $84.43 / $379.75	Facility	26	$73.42	$84.43	$379.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.15 / $368.14 / $646.08	Professional		$246.15	$368.14	$646.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.42 / $111.75 / $280.35	Professional	26	$73.42	$111.75	$280.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $172.73 / $247.18 / $393.09	Professional	TC	$172.73	$247.18	$393.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $207.18 / $257.79 / $530.59	Professional		$207.18	$257.79	$530.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $74.06 / $110.53 / $223.38	Professional	26	$74.06	$110.53	$223.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $151.55 / $171.13 / $171.13	Professional	TC	$151.55	$171.13	$171.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.62 / $124.62 / $124.62	Facility	26	$124.62	$124.62	$124.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.85 / $452.54 / $781.37	Professional		$257.85	$452.54	$781.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.20 / $124.80 / $229.48	Professional	26	$77.20	$124.80	$229.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $174.30 / $324.49 / $597.14	Professional	TC	$174.30	$324.49	$597.14
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $121.58 / $121.58 / $121.58	Facility	26	$121.58	$121.58	$121.58
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $293.06 / $418.66 / $583.51	Professional		$293.06	$418.66	$583.51
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $123.62 / $163.63	Professional	26	$85.11	$123.62	$163.63
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $207.96 / $297.08 / $414.06	Professional	TC	$207.96	$297.08	$414.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.56 / $237.74 / $439.80	Professional		$96.56	$237.74	$439.80
United Facility/Professional Professional Modifier Low / Median / High Price $310.89 / $491.54 / $1,147.97	Professional		$310.89	$491.54	$1,147.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.45 / $94.11 / $191.18	Professional	26	$64.45	$94.11	$191.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $216.84 / $372.04 / $1,012.06	Professional	TC	$216.84	$372.04	$1,012.06
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $264.68 / $264.68 / $264.68	Professional		$264.68	$264.68	$264.68
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $80.88 / $80.88 / $80.88	Professional	26	$80.88	$80.88	$80.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $183.80 / $183.80 / $183.80	Professional	TC	$183.80	$183.80	$183.80