Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.25 / $37.25 / $41.12	Facility	26	$37.25	$37.25	$41.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.88 / $245.09 / $410.24	Professional		$133.88	$245.09	$410.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.00 / $45.43 / $83.27	Professional	26	$38.00	$45.43	$83.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.76 / $201.25 / $334.90	Professional	TC	$92.76	$201.25	$334.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $189.16 / $189.16 / $189.16	Professional		$189.16	$189.16	$189.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.34 / $38.15 / $92.80	Professional	26	$33.34	$38.15	$92.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.19 / $52.19 / $136.93	Facility	26	$52.19	$52.19	$136.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.25 / $362.00 / $632.52	Professional		$228.25	$362.00	$632.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.70 / $61.96 / $108.24	Professional	26	$40.70	$61.96	$108.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $203.48 / $314.82 / $542.79	Professional	TC	$203.48	$314.82	$542.79
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $50.00 / $50.00	Facility	26	$50.00	$50.00	$50.00
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $165.52 / $252.53 / $373.88	Professional		$165.52	$252.53	$373.88
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $30.22 / $49.78 / $65.63	Professional	26	$30.22	$49.78	$65.63
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $135.30 / $207.90 / $311.85	Professional	TC	$135.30	$207.90	$311.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $241.52 / $392.26	Professional		$40.43	$241.52	$392.26
United Facility/Professional Professional Modifier Low / Median / High Price $218.80 / $323.06 / $555.77	Professional		$218.80	$323.06	$555.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.63 / $53.72 / $96.83	Professional	26	$36.63	$53.72	$96.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.62 / $265.80 / $453.71	Professional	TC	$181.62	$265.80	$453.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $196.09 / $196.09 / $196.09	Professional		$196.09	$196.09	$196.09
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $34.21 / $34.21 / $34.21	Professional	26	$34.21	$34.21	$34.21
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $161.88 / $161.88 / $205.42	Professional	TC	$161.88	$161.88	$205.42