Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.14 / $94.17 / $203.87	Facility	26	$86.14	$94.17	$203.87
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $37.96 / $38.39 / $50.55	Facility	53	$37.96	$38.39	$50.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.71 / $273.19 / $479.67	Professional		$194.71	$273.19	$479.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.09 / $116.15 / $349.57	Professional	26	$87.09	$116.15	$349.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $95.43 / $128.28 / $210.90	Professional	26	$95.43	$128.28	$210.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.36 / $120.36 / $316.19	Facility	26	$120.36	$120.36	$316.19
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $52.64 / $52.64 / $52.64	Facility	53	$52.64	$52.64	$52.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.66 / $343.71 / $615.45	Professional		$217.66	$343.71	$615.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.78 / $149.37 / $256.83	Professional	26	$99.78	$149.37	$256.83
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $114.60 / $114.60 / $114.60	Facility	26	$114.60	$114.60	$114.60
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $152.66 / $265.81 / $357.08	Professional		$152.66	$265.81	$357.08
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $70.37 / $114.60 / $150.41	Professional	26	$70.37	$114.60	$150.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.91 / $159.92 / $303.81	Professional		$97.91	$159.92	$303.81
United Facility/Professional Professional Modifier Low / Median / High Price $201.31 / $306.55 / $516.91	Professional		$201.31	$306.55	$516.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $86.53 / $124.20 / $214.64	Professional	26	$86.53	$124.20	$214.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $177.96 / $177.96 / $177.96	Professional		$177.96	$177.96	$177.96
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $79.66 / $79.66 / $79.66	Professional	26	$79.66	$79.66	$79.66