Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $247.94 / $273.70 / $363.87	Facility	26	$247.94	$273.70	$363.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $815.67 / $1,068.84 / $1,668.77	Professional		$815.67	$1,068.84	$1,668.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $260.13 / $310.64 / $663.28	Professional	26	$260.13	$310.64	$663.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $555.54 / $764.40 / $1,157.80	Professional	TC	$555.54	$764.40	$1,157.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $869.20 / $869.20 / $956.12	Professional		$869.20	$869.20	$956.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $269.20 / $289.48 / $484.14	Professional	26	$269.20	$289.48	$484.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $919.95 / $1,355.39 / $2,358.33	Professional		$919.95	$1,355.39	$2,358.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $271.42 / $409.57 / $721.20	Professional	26	$271.42	$409.57	$721.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $618.21 / $946.08 / $1,615.94	Professional	TC	$618.21	$946.08	$1,615.94
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $654.24 / $700.97 / $1,413.64	Professional		$654.24	$700.97	$1,413.64
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $202.63 / $217.11 / $437.84	Professional	26	$202.63	$217.11	$437.84
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $451.60 / $483.86 / $975.80	Professional	TC	$451.60	$483.86	$975.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $311.41 / $755.63 / $1,229.69	Professional		$311.41	$755.63	$1,229.69
United Facility/Professional Professional Modifier Low / Median / High Price $885.22 / $1,283.15 / $2,512.27	Professional		$885.22	$1,283.15	$2,512.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $255.09 / $393.36 / $684.61	Professional	26	$255.09	$393.36	$684.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $629.19 / $881.20 / $1,593.75	Professional	TC	$629.19	$881.20	$1,593.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $760.10 / $760.10 / $760.10	Professional		$760.10	$760.10	$760.10
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $219.07 / $219.07 / $219.07	Professional	26	$219.07	$219.07	$219.07
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $541.03 / $541.03 / $685.30	Professional	TC	$541.03	$541.03	$685.30