Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.81 / $56.42 / $64.98	Facility	26	$55.81	$56.42	$64.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.45 / $207.85 / $368.35	Professional		$165.45	$207.85	$368.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.42 / $73.20 / $133.10	Professional	26	$56.42	$73.20	$133.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.47 / $133.52 / $216.62	Professional	TC	$100.47	$133.52	$216.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $278.94 / $284.26 / $289.61	Professional		$278.94	$284.26	$289.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.39 / $61.66 / $107.02	Professional	26	$60.39	$61.66	$107.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.01 / $78.01 / $204.95	Facility	26	$78.01	$78.01	$204.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.69 / $251.73 / $431.72	Professional		$153.69	$251.73	$431.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.30 / $97.98 / $173.81	Professional	26	$64.30	$97.98	$173.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $101.51 / $166.14 / $295.22	Professional	TC	$101.51	$166.14	$295.22
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $74.23 / $74.23 / $74.23	Facility	26	$74.23	$74.23	$74.23
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $117.06 / $209.30 / $315.51	Professional		$117.06	$209.30	$315.51
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $45.45 / $65.84 / $99.40	Professional	26	$45.45	$65.84	$99.40
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $67.56 / $136.15 / $219.60	Professional	TC	$67.56	$136.15	$219.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $119.59 / $223.01	Professional		$65.88	$119.59	$223.01
United Facility/Professional Professional Modifier Low / Median / High Price $151.15 / $218.19 / $388.31	Professional		$151.15	$218.19	$388.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.93 / $83.68 / $137.56	Professional	26	$56.93	$83.68	$137.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.39 / $139.41 / $243.60	Professional	TC	$91.39	$139.41	$243.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $139.66 / $139.66 / $139.66	Professional		$139.66	$139.66	$139.66
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 $88.09 / $88.09 / $111.87	Professional	TC	$88.09	$88.09	$111.87