Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.06 / $50.06 / $56.22	Facility	26	$50.06	$50.06	$56.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.68 / $229.77 / $549.45	Professional		$180.68	$229.77	$549.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.66 / $66.94 / $268.00	Professional	26	$50.66	$66.94	$268.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.66 / $159.77 / $247.34	Professional	TC	$124.66	$159.77	$247.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $159.87 / $207.83 / $374.41	Professional		$159.87	$207.83	$374.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.35 / $46.35 / $106.17	Professional	26	$46.35	$46.35	$106.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.50 / $69.50 / $183.84	Facility	26	$69.50	$69.50	$183.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.90 / $288.83 / $494.85	Professional		$174.90	$288.83	$494.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.64 / $86.61 / $149.11	Professional	26	$57.64	$86.61	$149.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.41 / $213.19 / $357.61	Professional	TC	$144.41	$213.19	$357.61
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $66.66 / $66.66 / $66.66	Facility	26	$66.66	$66.66	$66.66
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $139.88 / $230.63 / $319.80	Professional		$139.88	$230.63	$319.80
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $40.54 / $66.66 / $89.24	Professional	26	$40.54	$66.66	$89.24
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $99.33 / $157.81 / $232.92	Professional	TC	$99.33	$157.81	$232.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.48 / $191.71 / $306.70	Professional		$41.48	$191.71	$306.70
United Facility/Professional Professional Modifier Low / Median / High Price $173.63 / $247.06 / $435.77	Professional		$173.63	$247.06	$435.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.81 / $73.92 / $126.11	Professional	26	$50.81	$73.92	$126.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $121.64 / $177.68 / $327.29	Professional	TC	$121.64	$177.68	$327.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $164.68 / $164.68 / $164.68	Professional		$164.68	$164.68	$164.68
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $45.96 / $45.96 / $45.96	Professional	26	$45.96	$45.96	$45.96
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $118.72 / $118.72 / $150.86	Professional	TC	$118.72	$118.72	$150.86