Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.97 / $31.38 / $124.23	Facility	26	$24.97	$31.38	$124.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.18 / $240.02 / $392.58	Professional		$210.18	$240.02	$392.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.97 / $32.34 / $95.40	Professional	26	$24.97	$32.34	$95.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $185.21 / $211.50 / $342.75	Professional	TC	$185.21	$211.50	$342.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $171.93 / $218.46 / $614.41	Professional		$171.93	$218.46	$614.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.19 / $48.14 / $77.25	Professional	26	$27.19	$48.14	$77.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.12 / $42.12 / $42.12	Facility	26	$42.12	$42.12	$42.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.68 / $311.80 / $539.29	Professional		$207.68	$311.80	$539.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.14 / $44.58 / $67.15	Professional	26	$26.14	$44.58	$67.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.54 / $268.27 / $478.08	Professional	TC	$181.54	$268.27	$478.08
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $191.15 / $210.77 / $452.60	Professional		$191.15	$210.77	$452.60
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $24.96 / $28.53 / $53.98	Professional	26	$24.96	$28.53	$53.98
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $166.19 / $182.58 / $415.66	Professional	TC	$166.19	$182.58	$415.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $279.04 / $479.76	Professional		$36.17	$279.04	$479.76
United Facility/Professional Professional Modifier Low / Median / High Price $197.38 / $271.32 / $534.41	Professional		$197.38	$271.32	$534.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.23 / $33.64 / $73.97	Professional	26	$29.23	$33.64	$73.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $170.56 / $245.04 / $494.03	Professional	TC	$170.56	$245.04	$494.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $197.66 / $197.66 / $197.66	Professional		$197.66	$197.66	$197.66
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.78 / $23.78 / $23.78	Professional	26	$23.78	$23.78	$23.78
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $173.88 / $173.88 / $173.88	Professional	TC	$173.88	$173.88	$173.88