Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.20 / $84.35 / $318.52	Facility	26	$66.20	$84.35	$318.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $219.67 / $256.73 / $509.10	Professional		$219.67	$256.73	$509.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.20 / $81.67 / $147.66	Professional	26	$66.20	$81.67	$147.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $153.47 / $177.09 / $323.29	Professional	TC	$153.47	$177.09	$323.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $259.83 / $259.83 / $478.46	Professional		$259.83	$259.83	$478.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.54 / $133.97 / $173.31	Professional	26	$77.54	$133.97	$173.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.54 / $116.54 / $116.54	Facility	26	$116.54	$116.54	$116.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.97 / $402.50 / $583.16	Professional		$267.97	$402.50	$583.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.34 / $127.97 / $182.50	Professional	26	$80.34	$127.97	$182.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $184.00 / $277.77 / $409.59	Professional	TC	$184.00	$277.77	$409.59
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $227.35 / $243.59 / $387.83	Professional		$227.35	$243.59	$387.83
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $69.45 / $74.43 / $119.67	Professional	26	$69.45	$74.43	$119.67
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $157.88 / $169.16 / $269.33	Professional	TC	$157.88	$169.16	$269.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $234.12 / $416.22	Professional		$95.09	$234.12	$416.22
United Facility/Professional Professional Modifier Low / Median / High Price $253.93 / $343.21 / $583.46	Professional		$253.93	$343.21	$583.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.42 / $108.69 / $188.14	Professional	26	$81.42	$108.69	$188.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $172.81 / $235.98 / $403.09	Professional	TC	$172.81	$235.98	$403.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $191.53 / $191.53 / $191.53	Professional		$191.53	$191.53	$191.53
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $55.90 / $55.90 / $55.90	Professional	26	$55.90	$55.90	$55.90
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $135.63 / $135.63 / $135.63	Professional	TC	$135.63	$135.63	$135.63