Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $70.79 / $125.89	Facility	26	$66.07	$70.79	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $316.23 / $851.14	Professional		$213.80	$316.23	$851.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $112.20 / $380.19	Professional	26	$75.86	$112.20	$380.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $173.78 / $346.74	Professional	TC	$123.03	$173.78	$346.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $234.42 / $398.11	Professional		$194.98	$234.42	$398.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $100.00 / $141.25	Professional	26	$79.43	$100.00	$141.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $93.33 / $158.49	Facility	26	$19.95	$93.33	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $316.23 / $562.34	Professional		$199.53	$316.23	$562.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $117.49 / $213.80	Professional	26	$79.43	$117.49	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $204.17 / $371.54	Professional	TC	$141.25	$204.17	$371.54
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $89.13 / $89.13	Facility	26	$89.13	$89.13	$89.13
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $245.47 / $371.54	Professional		$158.49	$245.47	$371.54
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $79.43 / $120.23	Professional	26	$56.23	$79.43	$120.23
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $158.49 / $251.19	Professional	TC	$102.33	$158.49	$251.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $117.49 / $245.47	Professional		$32.36	$117.49	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $269.15 / $446.68	Professional		$190.55	$269.15	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $100.00 / $169.82	Professional	26	$69.18	$100.00	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $169.82 / $288.40	Professional	TC	$123.03	$169.82	$288.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $229.09	Professional		$173.78	$173.78	$229.09
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $61.66 / $81.28	Professional	26	$61.66	$61.66	$81.28
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $114.82 / $147.91	Professional	TC	$114.82	$114.82	$147.91