Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.24 / $40.33 / $162.38	Facility	26	$33.24	$40.33	$162.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.99 / $243.45 / $499.81	Professional		$210.99	$243.45	$499.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.24 / $41.96 / $107.69	Professional	26	$33.24	$41.96	$107.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.75 / $205.10 / $358.35	Professional	TC	$177.75	$205.10	$358.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $191.63 / $191.63 / $231.24	Professional		$191.63	$191.63	$231.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.17 / $70.11 / $105.17	Professional	26	$27.17	$70.11	$105.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.82 / $56.82 / $56.82	Facility	26	$56.82	$56.82	$56.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.97 / $364.38 / $615.37	Professional		$208.97	$364.38	$615.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.79 / $61.71 / $90.81	Professional	26	$34.79	$61.71	$90.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $174.18 / $320.86 / $525.97	Professional	TC	$174.18	$320.86	$525.97
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $191.62 / $219.00 / $450.70	Professional		$191.62	$219.00	$450.70
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $36.39 / $73.65	Professional	26	$33.22	$36.39	$73.65
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $158.40 / $180.40 / $399.59	Professional	TC	$158.40	$180.40	$399.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.97 / $255.93 / $446.78	Professional		$38.97	$255.93	$446.78
United Facility/Professional Professional Modifier Low / Median / High Price $250.33 / $282.57 / $576.59	Professional		$250.33	$282.57	$576.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.15 / $45.71 / $92.02	Professional	26	$40.15	$45.71	$92.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $212.50 / $240.74 / $485.13	Professional	TC	$212.50	$240.74	$485.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $206.05 / $206.05 / $206.05	Professional		$206.05	$206.05	$206.05
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.29 / $33.29 / $33.29	Professional	26	$33.29	$33.29	$33.29
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $172.77 / $172.77 / $172.77	Professional	TC	$172.77	$172.77	$172.77