Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.26 / $53.74 / $173.81	Facility	26	$33.26	$53.74	$173.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $244.88 / $282.55 / $456.38	Professional		$244.88	$282.55	$456.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.26 / $41.82 / $87.91	Professional	26	$33.26	$41.82	$87.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $211.62 / $242.92 / $389.63	Professional	TC	$211.62	$242.92	$389.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $196.00 / $230.59 / $292.25	Professional		$196.00	$230.59	$292.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.24 / $64.92 / $105.15	Professional	26	$38.24	$64.92	$105.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.28 / $57.28 / $57.28	Facility	26	$57.28	$57.28	$57.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.55 / $389.74 / $633.69	Professional		$239.55	$389.74	$633.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.04 / $61.05 / $91.00	Professional	26	$35.04	$61.05	$91.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.51 / $333.76 / $544.01	Professional	TC	$204.51	$333.76	$544.01
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $218.26 / $247.05 / $459.51	Professional		$218.26	$247.05	$459.51
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $33.46 / $38.24 / $71.83	Professional	26	$33.46	$38.24	$71.83
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $184.80 / $211.20 / $410.66	Professional	TC	$184.80	$211.20	$410.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.13 / $313.92 / $539.73	Professional		$37.13	$313.92	$539.73
United Facility/Professional Professional Modifier Low / Median / High Price $260.93 / $325.16 / $674.77	Professional		$260.93	$325.16	$674.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.08 / $44.58 / $87.71	Professional	26	$39.08	$44.58	$87.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $220.60 / $280.14 / $549.79	Professional	TC	$220.60	$280.14	$549.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $210.27 / $210.27 / $210.27	Professional		$210.27	$210.27	$210.27
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $29.86 / $29.86 / $29.86	Professional	26	$29.86	$29.86	$29.86
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $180.40 / $180.40 / $180.40	Professional	TC	$180.40	$180.40	$180.40