Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.73 / $89.28 / $328.61	Facility	26	$68.73	$89.28	$328.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.94 / $343.32 / $675.18	Professional		$281.94	$343.32	$675.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.73 / $90.71 / $214.35	Professional	26	$68.73	$90.71	$214.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $213.21 / $253.52 / $496.82	Professional	TC	$213.21	$253.52	$496.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $298.31 / $314.07 / $611.20	Professional		$298.31	$314.07	$611.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.17 / $136.97 / $166.30	Professional	26	$81.17	$136.97	$166.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.59 / $119.59 / $119.59	Facility	26	$119.59	$119.59	$119.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.51 / $531.38 / $790.90	Professional		$321.51	$531.38	$790.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.14 / $130.69 / $189.48	Professional	26	$82.14	$130.69	$189.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $243.45 / $399.62 / $604.80	Professional	TC	$243.45	$399.62	$604.80
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $261.02 / $279.67 / $510.14	Professional		$261.02	$279.67	$510.14
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $71.02 / $76.09 / $123.23	Professional	26	$71.02	$76.09	$123.23
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $190.00 / $208.19 / $391.11	Professional	TC	$190.00	$208.19	$391.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.81 / $301.01 / $509.16	Professional		$96.81	$301.01	$509.16
United Facility/Professional Professional Modifier Low / Median / High Price $353.18 / $480.27 / $783.46	Professional		$353.18	$480.27	$783.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.37 / $112.24 / $201.25	Professional	26	$83.37	$112.24	$201.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $260.75 / $351.51 / $609.41	Professional	TC	$260.75	$351.51	$609.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $273.27 / $273.27 / $273.27	Professional		$273.27	$273.27	$273.27
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $69.83 / $69.83 / $69.83	Professional	26	$69.83	$69.83	$69.83
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $203.46 / $203.46 / $203.46	Professional	TC	$203.46	$203.46	$203.46