Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $306.92 / $306.92 / $519.88	Facility		$306.92	$306.92	$519.88
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $218.87 / $218.87 / $218.87	Facility	26	$218.87	$218.87	$218.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $496.67 / $533.80 / $569.09	Facility	TC	$496.67	$533.80	$569.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.56 / $205.80 / $429.71	Professional		$165.56	$205.80	$429.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.86 / $84.39 / $595.20	Professional	26	$50.86	$84.39	$595.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.67 / $131.54 / $299.91	Professional	TC	$83.67	$131.54	$299.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.12 / $139.74 / $272.24	Professional		$129.12	$139.74	$272.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $53.43 / $124.46	Professional	26	$13.00	$53.43	$124.46
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $95.05 / $147.24 / $177.67	Professional	TC	$95.05	$147.24	$177.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.64 / $211.23 / $402.82	Professional		$122.64	$211.23	$402.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.03 / $72.23 / $131.16	Professional	26	$40.03	$72.23	$131.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.57 / $132.88 / $279.45	Professional	TC	$82.57	$132.88	$279.45
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $113.43 / $189.12 / $378.24	Professional		$113.43	$189.12	$378.24
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $57.50 / $90.34 / $113.49	Professional	26	$57.50	$90.34	$113.49
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $56.56 / $114.80 / $229.60	Professional	TC	$56.56	$114.80	$229.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $102.54 / $217.13 / $371.54	Professional		$102.54	$217.13	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $115.43 / $163.84 / $594.80	Professional		$115.43	$163.84	$594.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.46 / $51.31 / $208.85	Professional	26	$39.46	$51.31	$208.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.70 / $111.93 / $389.76	Professional	TC	$73.70	$111.93	$389.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $98.80 / $219.55 / $219.55	Professional		$98.80	$219.55	$219.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.23 / $60.50 / $60.50	Professional	26	$27.23	$60.50	$60.50
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $71.56 / $159.05 / $159.05	Professional	TC	$71.56	$159.05	$159.05