Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $387.47 / $387.47 / $387.47	Facility	26	$387.47	$387.47	$387.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.08 / $296.58 / $517.22	Professional		$197.08	$296.58	$517.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.25 / $123.47 / $515.90	Professional	26	$87.25	$123.47	$515.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.66 / $181.94 / $355.84	Professional	TC	$114.66	$181.94	$355.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $198.60 / $376.94 / $397.21	Professional		$198.60	$376.94	$397.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $130.03 / $218.34	Professional	26	$13.00	$130.03	$218.34
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $204.72 / $204.72 / $246.92	Professional	TC	$204.72	$204.72	$246.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.86 / $321.51 / $607.00	Professional		$182.86	$321.51	$607.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.09 / $121.62 / $231.28	Professional	26	$70.09	$121.62	$231.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.61 / $176.76 / $396.92	Professional	TC	$114.61	$176.76	$396.92
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $193.52 / $300.37 / $568.20	Professional		$193.52	$300.37	$568.20
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $100.72 / $133.21 / $254.87	Professional	26	$100.72	$133.21	$254.87
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $76.97 / $156.65 / $318.24	Professional	TC	$76.97	$156.65	$318.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $138.28 / $320.87 / $537.13	Professional		$138.28	$320.87	$537.13
United Facility/Professional Professional Modifier Low / Median / High Price $172.04 / $256.60 / $855.32	Professional		$172.04	$256.60	$855.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.51 / $90.41 / $345.05	Professional	26	$69.51	$90.41	$345.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.39 / $157.69 / $550.00	Professional	TC	$100.39	$157.69	$550.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $147.51 / $327.80 / $327.80	Professional		$147.51	$327.80	$327.80
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $48.02 / $106.71 / $106.71	Professional	26	$48.02	$106.71	$106.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $99.49 / $221.09 / $221.09	Professional	TC	$99.49	$221.09	$221.09