Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.98 / $32.75 / $135.34	Facility	26	$26.98	$32.75	$135.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.50 / $209.53 / $386.87	Professional		$189.50	$209.53	$386.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.98 / $32.81 / $87.41	Professional	26	$26.98	$32.81	$87.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.52 / $173.55 / $299.18	Professional	TC	$162.52	$173.55	$299.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.05 / $186.31 / $548.66	Professional		$149.05	$186.31	$548.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.31 / $57.51 / $85.94	Professional	26	$30.31	$57.51	$85.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.62 / $45.62 / $45.62	Facility	26	$45.62	$45.62	$45.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.26 / $294.72 / $486.08	Professional		$181.26	$294.72	$486.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.24 / $49.21 / $73.16	Professional	26	$28.24	$49.21	$73.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.91 / $241.19 / $420.19	Professional	TC	$157.91	$241.19	$420.19
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $170.69 / $193.29 / $338.15	Professional		$170.69	$193.29	$338.15
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $26.97 / $30.83 / $58.25	Professional	26	$26.97	$30.83	$58.25
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $143.72 / $163.69 / $296.81	Professional	TC	$143.72	$163.69	$296.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $245.18 / $425.67	Professional		$36.17	$245.18	$425.67
United Facility/Professional Professional Modifier Low / Median / High Price $186.84 / $252.59 / $485.07	Professional		$186.84	$252.59	$485.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.22 / $36.18 / $71.39	Professional	26	$32.22	$36.18	$71.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $153.30 / $211.42 / $427.34	Professional	TC	$153.30	$211.42	$427.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $154.69 / $154.69 / $154.69	Professional		$154.69	$154.69	$154.69
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.59 / $22.59 / $22.59	Professional	26	$22.59	$22.59	$22.59
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $132.10 / $132.10 / $132.10	Professional	TC	$132.10	$132.10	$132.10