Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.85 / $31.88 / $123.97	Facility	26	$24.85	$31.88	$123.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.30 / $205.73 / $439.01	Professional		$178.30	$205.73	$439.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.85 / $33.86 / $86.18	Professional	26	$24.85	$33.86	$86.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $153.44 / $166.88 / $331.97	Professional	TC	$153.44	$166.88	$331.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $197.34 / $209.67 / $404.32	Professional		$197.34	$209.67	$404.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.98 / $39.13 / $60.60	Professional	26	$28.98	$39.13	$60.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.72 / $42.72 / $42.72	Facility	26	$42.72	$42.72	$42.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.55 / $280.27 / $442.53	Professional		$181.55	$280.27	$442.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.54 / $45.36 / $66.40	Professional	26	$29.54	$45.36	$66.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.87 / $245.29 / $381.54	Professional	TC	$154.87	$245.29	$381.54
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $172.67 / $182.59 / $294.55	Professional		$172.67	$182.59	$294.55
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $25.36 / $27.17 / $43.26	Professional	26	$25.36	$27.17	$43.26
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $140.58 / $152.62 / $251.29	Professional	TC	$140.58	$152.62	$251.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.97 / $245.18 / $367.77	Professional		$35.97	$245.18	$367.77
United Facility/Professional Professional Modifier Low / Median / High Price $174.06 / $231.81 / $499.12	Professional		$174.06	$231.81	$499.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.51 / $37.50 / $70.23	Professional	26	$28.51	$37.50	$70.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $142.69 / $197.16 / $415.96	Professional	TC	$142.69	$197.16	$415.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $120.46 / $120.46 / $120.46	Professional		$120.46	$120.46	$120.46
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $16.70 / $16.70 / $16.70	Professional	26	$16.70	$16.70	$16.70
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $103.76 / $103.76 / $103.76	Professional	TC	$103.76	$103.76	$103.76