Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $145.84 / $192.10 / $745.03	Facility	26	$145.84	$192.10	$745.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $307.83 / $461.74 / $867.95	Professional		$307.83	$461.74	$867.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $145.84 / $220.49 / $603.90	Professional	26	$145.84	$220.49	$603.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $161.99 / $242.98 / $467.91	Professional	TC	$161.99	$242.98	$467.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $364.83 / $387.63 / $747.50	Professional		$364.83	$387.63	$747.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $174.63 / $235.58 / $358.09	Professional	26	$174.63	$235.58	$358.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $256.04 / $256.04 / $256.04	Facility	26	$256.04	$256.04	$256.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.21 / $629.94 / $1,366.28	Professional		$363.21	$629.94	$1,366.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $180.21 / $279.83 / $407.47	Professional	26	$180.21	$279.83	$407.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.39 / $336.55 / $909.16	Professional	TC	$194.39	$336.55	$909.16
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $319.23 / $344.66 / $1,385.67	Professional		$319.23	$344.66	$1,385.67
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $152.80 / $163.72 / $280.17	Professional	26	$152.80	$163.72	$280.17
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $166.42 / $183.25 / $1,050.24	Professional	TC	$166.42	$183.25	$1,050.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $178.13 / $292.49 / $574.20	Professional		$178.13	$292.49	$574.20
United Facility/Professional Professional Modifier Low / Median / High Price $386.33 / $612.95 / $1,190.35	Professional		$386.33	$612.95	$1,190.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $179.49 / $236.30 / $395.12	Professional	26	$179.49	$236.30	$395.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $201.80 / $329.01 / $834.81	Professional	TC	$201.80	$329.01	$834.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $292.95 / $292.95 / $292.95	Professional		$292.95	$292.95	$292.95
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $136.12 / $136.12 / $136.12	Professional	26	$136.12	$136.12	$136.12
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $156.84 / $156.84 / $156.84	Professional	TC	$156.84	$156.84	$156.84