Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.89 / $40.07 / $160.32	Facility	26	$31.89	$40.07	$160.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $219.23 / $252.95 / $449.02	Professional		$219.23	$252.95	$449.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.89 / $37.21 / $67.11	Professional	26	$31.89	$37.21	$67.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.34 / $213.94 / $377.22	Professional	TC	$187.34	$213.94	$377.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $183.22 / $242.03 / $644.15	Professional		$183.22	$242.03	$644.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.92 / $61.74 / $98.08	Professional	26	$35.92	$61.74	$98.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.48 / $54.48 / $54.48	Facility	26	$54.48	$54.48	$54.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.82 / $368.53 / $577.22	Professional		$217.82	$368.53	$577.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.38 / $58.16 / $86.63	Professional	26	$33.38	$58.16	$86.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $184.44 / $313.33 / $490.69	Professional	TC	$184.44	$313.33	$490.69
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $200.40 / $226.90 / $465.54	Professional		$200.40	$226.90	$465.54
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $31.87 / $36.43 / $69.50	Professional	26	$31.87	$36.43	$69.50
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $168.53 / $191.96 / $419.32	Professional	TC	$168.53	$191.96	$419.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.44 / $279.04 / $479.76	Professional		$37.44	$279.04	$479.76
United Facility/Professional Professional Modifier Low / Median / High Price $236.43 / $290.02 / $591.01	Professional		$236.43	$290.02	$591.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.56 / $42.54 / $95.26	Professional	26	$37.56	$42.54	$95.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $197.20 / $247.49 / $510.98	Professional	TC	$197.20	$247.49	$510.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $212.99 / $212.99 / $212.99	Professional		$212.99	$212.99	$212.99
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $31.61 / $31.61 / $31.61	Professional	26	$31.61	$31.61	$31.61
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $181.38 / $181.38 / $181.38	Professional	TC	$181.38	$181.38	$181.38