Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.98 / $79.11 / $273.23	Facility	26	$52.98	$79.11	$273.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $308.98 / $451.27 / $809.42	Professional		$308.98	$451.27	$809.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.98 / $79.06 / $473.63	Professional	26	$52.98	$79.06	$473.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $256.00 / $364.99 / $616.69	Professional	TC	$256.00	$364.99	$616.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $325.22 / $345.55 / $666.34	Professional		$325.22	$345.55	$666.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.57 / $95.35 / $132.53	Professional	26	$63.57	$95.35	$132.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.59 / $93.59 / $93.59	Facility	26	$93.59	$93.59	$93.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $348.83 / $561.64 / $875.74	Professional		$348.83	$561.64	$875.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.30 / $99.32 / $147.16	Professional	26	$64.30	$99.32	$147.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $294.83 / $477.37 / $726.33	Professional	TC	$294.83	$477.37	$726.33
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $284.57 / $304.89 / $536.29	Professional		$284.57	$304.89	$536.29
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $55.62 / $59.59 / $94.88	Professional	26	$55.62	$59.59	$94.88
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $228.95 / $245.30 / $431.47	Professional	TC	$228.95	$245.30	$431.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $362.42 / $603.94	Professional		$95.09	$362.42	$603.94
United Facility/Professional Professional Modifier Low / Median / High Price $369.53 / $485.42 / $878.41	Professional		$369.53	$485.42	$878.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.67 / $83.07 / $144.79	Professional	26	$63.67	$83.07	$144.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $311.72 / $408.01 / $727.61	Professional	TC	$311.72	$408.01	$727.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $308.11 / $308.11 / $308.11	Professional		$308.11	$308.11	$308.11
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $56.21 / $56.21 / $56.21	Professional	26	$56.21	$56.21	$56.21
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $251.90 / $251.90 / $251.90	Professional	TC	$251.90	$251.90	$251.90