Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.96 / $125.81 / $470.97	Facility	26	$98.96	$125.81	$470.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.97 / $317.47 / $599.37	Professional		$275.97	$317.47	$599.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.96 / $114.18 / $242.46	Professional	26	$98.96	$114.18	$242.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.01 / $189.15 / $346.92	Professional	TC	$177.01	$189.15	$346.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $363.84 / $363.84 / $363.84	Professional		$363.84	$363.84	$363.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $154.69 / $154.69 / $154.69	Professional	26	$154.69	$154.69	$154.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $172.76 / $172.76 / $172.76	Facility	26	$172.76	$172.76	$172.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $324.35 / $474.18 / $681.29	Professional		$324.35	$474.18	$681.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $119.63 / $189.65 / $271.94	Professional	26	$119.63	$189.65	$271.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.10 / $284.26 / $442.41	Professional	TC	$204.10	$284.26	$442.41
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $302.72 / $324.33 / $516.39	Professional		$302.72	$324.33	$516.39
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $103.61 / $111.01 / $177.11	Professional	26	$103.61	$111.01	$177.11
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $195.89 / $211.78 / $333.28	Professional	TC	$195.89	$211.78	$333.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $151.09 / $312.33 / $578.78	Professional		$151.09	$312.33	$578.78
United Facility/Professional Professional Modifier Low / Median / High Price $289.05 / $403.75 / $742.38	Professional		$289.05	$403.75	$742.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $121.18 / $160.15 / $266.88	Professional	26	$121.18	$160.15	$266.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.06 / $225.47 / $442.97	Professional	TC	$169.06	$225.47	$442.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $203.46 / $203.46 / $203.46	Professional		$203.46	$203.46	$203.46
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $66.73 / $66.73 / $66.73	Professional	26	$66.73	$66.73	$66.73
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $136.72 / $136.72 / $136.72	Professional	TC	$136.72	$136.72	$136.72