Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.29 / $83.93 / $739.67	Facility	26	$50.29	$83.93	$739.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $300.36 / $405.42 / $767.86	Professional		$300.36	$405.42	$767.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.30 / $69.73 / $193.95	Professional	26	$50.30	$69.73	$193.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $250.06 / $288.52 / $498.33	Professional	TC	$250.06	$288.52	$498.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $244.63 / $328.91 / $638.46	Professional		$244.63	$328.91	$638.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.82 / $82.57 / $132.46	Professional	26	$56.82	$82.57	$132.46
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $254.17 / $270.24 / $515.20	Professional	TC	$254.17	$270.24	$515.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.17 / $86.17 / $86.17	Facility	26	$86.17	$86.17	$86.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.20 / $531.86 / $804.64	Professional		$296.20	$531.86	$804.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.98 / $93.40 / $136.90	Professional	26	$52.98	$93.40	$136.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $243.23 / $452.53 / $702.85	Professional	TC	$243.23	$452.53	$702.85
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $272.66 / $308.36 / $633.60	Professional		$272.66	$308.36	$633.60
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $50.26 / $57.44 / $108.20	Professional	26	$50.26	$57.44	$108.20
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $222.40 / $253.35 / $530.54	Professional	TC	$222.40	$253.35	$530.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.97 / $331.79 / $608.11	Professional		$96.97	$331.79	$608.11
United Facility/Professional Professional Modifier Low / Median / High Price $359.71 / $471.09 / $854.22	Professional		$359.71	$471.09	$854.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.28 / $80.73 / $153.22	Professional	26	$60.28	$80.73	$153.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $297.08 / $371.86 / $700.57	Professional	TC	$297.08	$371.86	$700.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $290.02 / $290.02 / $290.02	Professional		$290.02	$290.02	$290.02
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $49.75 / $49.75 / $49.75	Professional	26	$49.75	$49.75	$49.75
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $240.28 / $240.28 / $240.28	Professional	TC	$240.28	$240.28	$240.28