Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.23 / $1,588.88 / $3,423.68	Facility		$478.23	$1,588.88	$3,423.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.19 / $63.42 / $536.00	Facility	26	$55.19	$63.42	$536.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.11 / $230.13 / $551.00	Professional		$176.11	$230.13	$551.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.45 / $75.34 / $275.00	Professional	26	$57.45	$75.34	$275.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.69 / $147.47 / $265.89	Professional	TC	$112.69	$147.47	$265.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $122.87 / $151.52 / $296.14	Professional		$122.87	$151.52	$296.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.95 / $67.42 / $107.02	Professional	26	$51.95	$67.42	$107.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $92.60 / $98.48 / $253.44	Professional	TC	$92.60	$98.48	$253.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $219.59 / $716.68 / $1,119.79	Facility		$219.59	$716.68	$1,119.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.01 / $78.01 / $210.96	Facility	26	$78.01	$78.01	$210.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.56 / $289.39 / $504.85	Professional		$167.56	$289.39	$504.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.28 / $93.85 / $168.58	Professional	26	$62.28	$93.85	$168.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $118.30 / $197.94 / $349.42	Professional	TC	$118.30	$197.94	$349.42
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $195.70 / $225.35 / $237.21	Facility		$195.70	$225.35	$237.21
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 $126.48 / $239.35 / $310.83	Professional		$126.48	$239.35	$310.83
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $45.45 / $67.81 / $89.71	Professional	26	$45.45	$67.81	$89.71
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $81.02 / $168.42 / $221.50	Professional	TC	$81.02	$168.42	$221.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.92 / $142.04 / $240.76	Professional		$65.92	$142.04	$240.76
United Facility/Professional Professional Modifier Low / Median / High Price $167.88 / $253.79 / $453.51	Professional		$167.88	$253.79	$453.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.59 / $80.25 / $135.57	Professional	26	$53.59	$80.25	$135.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.26 / $171.22 / $322.10	Professional	TC	$110.26	$171.22	$322.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $148.34 / $148.34 / $148.34	Professional		$148.34	$148.34	$148.34
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $51.57 / $51.57 / $51.57	Professional	26	$51.57	$51.57	$51.57
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $96.77 / $96.77 / $123.10	Professional	TC	$96.77	$96.77	$123.10