Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.41 / $25.28 / $112.01	Facility	26	$23.41	$25.28	$112.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $238.99 / $532.69	Professional		$207.13	$238.99	$532.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.41 / $30.39 / $136.50	Professional	26	$23.41	$30.39	$136.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $183.72 / $211.98 / $371.66	Professional	TC	$183.72	$211.98	$371.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $171.09 / $213.86 / $601.49	Professional		$171.09	$213.86	$601.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $29.42 / $70.47	Professional	26	$24.07	$29.42	$70.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.78 / $39.78 / $39.78	Facility	26	$39.78	$39.78	$39.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.26 / $382.15 / $592.12	Professional		$204.26	$382.15	$592.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.50 / $42.51 / $63.68	Professional	26	$24.50	$42.51	$63.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.76 / $338.87 / $546.03	Professional	TC	$179.76	$338.87	$546.03
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $187.13 / $213.86 / $445.31	Professional		$187.13	$213.86	$445.31
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $23.41 / $25.72 / $50.67	Professional	26	$23.41	$25.72	$50.67
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $163.72 / $186.45 / $416.91	Professional	TC	$163.72	$186.45	$416.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $279.04 / $478.36	Professional		$36.17	$279.04	$478.36
United Facility/Professional Professional Modifier Low / Median / High Price $253.43 / $278.33 / $568.45	Professional		$253.43	$278.33	$568.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.78 / $31.50 / $60.46	Professional	26	$27.78	$31.50	$60.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.29 / $253.59 / $503.17	Professional	TC	$223.29	$253.59	$503.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $203.72 / $203.72 / $203.72	Professional		$203.72	$203.72	$203.72
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.58 / $23.58 / $23.58	Professional	26	$23.58	$23.58	$23.58
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $180.14 / $180.14 / $180.14	Professional	TC	$180.14	$180.14	$180.14