Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.36 / $46.95 / $180.66	Facility	26	$37.36	$46.95	$180.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.42 / $251.52 / $406.39	Professional		$223.42	$251.52	$406.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.36 / $43.11 / $74.81	Professional	26	$37.36	$43.11	$74.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.06 / $213.51 / $342.75	Professional	TC	$186.06	$213.51	$342.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $185.78 / $209.01 / $290.27	Professional		$185.78	$209.01	$290.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $72.02 / $72.02 / $87.45	Professional	26	$72.02	$72.02	$87.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.78 / $63.78 / $63.78	Facility	26	$63.78	$63.78	$63.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.99 / $413.79 / $628.45	Professional		$220.99	$413.79	$628.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.45 / $68.56 / $101.41	Professional	26	$39.45	$68.56	$101.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.54 / $344.10 / $530.80	Professional	TC	$181.54	$344.10	$530.80
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $203.20 / $232.23 / $480.81	Professional		$203.20	$232.23	$480.81
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $37.35 / $40.94 / $81.20	Professional	26	$37.35	$40.94	$81.20
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $165.85 / $189.55 / $403.48	Professional	TC	$165.85	$189.55	$403.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $281.36 / $486.49	Professional		$41.40	$281.36	$486.49
United Facility/Professional Professional Modifier Low / Median / High Price $274.73 / $307.30 / $641.50	Professional		$274.73	$307.30	$641.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.15 / $50.85 / $105.28	Professional	26	$45.15	$50.85	$105.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.22 / $256.60 / $509.78	Professional	TC	$229.22	$256.60	$509.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $210.16 / $210.16 / $210.16	Professional		$210.16	$210.16	$210.16
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $36.08 / $36.08 / $36.08	Professional	26	$36.08	$36.08	$36.08
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $174.07 / $174.07 / $174.07	Professional	TC	$174.07	$174.07	$174.07