Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $165.71 / $165.71 / $165.71	Facility	26	$165.71	$165.71	$165.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $280.39 / $1,153.07	Professional		$134.88	$280.39	$1,153.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.46 / $52.42 / $269.95	Professional	26	$39.46	$52.42	$269.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.67 / $220.17 / $384.98	Professional	TC	$92.67	$220.17	$384.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $72.08 / $96.97	Professional	26	$13.00	$72.08	$96.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.61 / $230.81 / $569.53	Professional		$109.61	$230.81	$569.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.48 / $53.22 / $101.44	Professional	26	$31.48	$53.22	$101.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.54 / $189.88 / $473.29	Professional	TC	$76.54	$189.88	$473.29
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $153.44 / $227.11 / $430.37	Professional		$153.44	$227.11	$430.37
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $46.30 / $68.53 / $89.62	Professional	26	$46.30	$68.53	$89.62
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $107.16 / $158.59 / $358.35	Professional	TC	$107.16	$158.59	$358.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.53 / $361.71 / $497.23	Professional		$41.53	$361.71	$497.23
United Facility/Professional Professional Modifier Low / Median / High Price $119.37 / $235.75 / $823.56	Professional		$119.37	$235.75	$823.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.68 / $40.64 / $160.56	Professional	26	$30.68	$40.64	$160.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.13 / $195.61 / $688.58	Professional	TC	$82.13	$195.61	$688.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $99.45 / $220.99 / $220.99	Professional		$99.45	$220.99	$220.99
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $15.99 / $35.53 / $35.53	Professional	26	$15.99	$35.53	$35.53
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $83.46 / $185.46 / $185.46	Professional	TC	$83.46	$185.46	$185.46