Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $50.12 / $165.96	Facility	26	$30.20	$50.12	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $218.78 / $416.87	Professional		$144.54	$218.78	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $44.67 / $102.33	Professional	26	$30.20	$44.67	$102.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $173.78 / $295.12	Professional	TC	$114.82	$173.78	$295.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $165.96 / $354.81	Professional		$125.89	$165.96	$354.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $57.54 / $74.13	Professional	26	$36.31	$57.54	$74.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $194.98 / $194.98	Professional	TC	$194.98	$194.98	$194.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $51.29 / $74.13	Facility	26	$10.96	$51.29	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $275.42 / $457.09	Professional		$144.54	$275.42	$457.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $54.95 / $91.20	Professional	26	$31.62	$54.95	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $218.78 / $380.19	Professional	TC	$112.20	$218.78	$380.19
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $151.36 / $309.03	Professional		$141.25	$151.36	$309.03
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $33.88 / $63.10	Professional	26	$31.62	$33.88	$63.10
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $120.23 / $245.47	Professional	TC	$109.65	$120.23	$245.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $97.72 / $169.82	Professional		$32.36	$97.72	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $208.93 / $398.11	Professional		$173.78	$208.93	$398.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $41.69 / $81.28	Professional	26	$36.31	$41.69	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $169.82 / $316.23	Professional	TC	$141.25	$169.82	$316.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $154.88 / $199.53	Professional		$107.15	$154.88	$199.53
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $33.88 / $44.67	Professional	26	$23.44	$33.88	$44.67
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $120.23 / $154.88	Professional	TC	$85.11	$120.23	$154.88