Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $271.89 / $358.83 / $1,387.19	Facility	26	$271.89	$358.83	$1,387.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,198.49 / $1,774.22 / $3,099.63	Professional		$1,198.49	$1,774.22	$3,099.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $271.89 / $405.68 / $1,128.59	Professional	26	$271.89	$405.68	$1,128.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $926.59 / $1,297.73 / $2,268.77	Professional	TC	$926.59	$1,297.73	$2,268.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,373.91 / $1,498.19 / $2,814.97	Professional		$1,373.91	$1,498.19	$2,814.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $329.46 / $489.31 / $668.36	Professional	26	$329.46	$489.31	$668.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $477.29 / $477.29 / $477.29	Facility	26	$477.29	$477.29	$477.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,408.61 / $2,337.63 / $3,428.34	Professional		$1,408.61	$2,337.63	$3,428.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $329.73 / $514.47 / $751.19	Professional	26	$329.73	$514.47	$751.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,111.96 / $1,819.48 / $2,746.73	Professional	TC	$1,111.96	$1,819.48	$2,746.73
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $1,202.17 / $1,290.29 / $2,265.57	Professional		$1,202.17	$1,290.29	$2,265.57
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $285.43 / $305.82 / $489.62	Professional	26	$285.43	$305.82	$489.62
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $916.74 / $982.22 / $1,727.66	Professional	TC	$916.74	$982.22	$1,727.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $380.48 / $1,428.45 / $2,397.21	Professional		$380.48	$1,428.45	$2,397.21
United Facility/Professional Professional Modifier Low / Median / High Price $1,494.89 / $2,046.56 / $3,422.62	Professional		$1,494.89	$2,046.56	$3,422.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $323.11 / $429.47 / $785.93	Professional	26	$323.11	$429.47	$785.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,150.42 / $1,583.05 / $2,633.63	Professional	TC	$1,150.42	$1,583.05	$2,633.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,198.70 / $1,198.70 / $1,198.70	Professional		$1,198.70	$1,198.70	$1,198.70
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $270.44 / $270.44 / $270.44	Professional	26	$270.44	$270.44	$270.44
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $928.26 / $928.26 / $928.26	Professional	TC	$928.26	$928.26	$928.26