Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $221.04 / $801.88 / $1,486.39	Facility		$221.04	$801.88	$1,486.39
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.66 / $31.67 / $41.53	Facility	26	$24.66	$31.67	$41.53
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $147.68 / $382.94 / $756.91	Facility	TC	$147.68	$382.94	$756.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.49 / $235.87 / $512.10	Professional		$178.49	$235.87	$512.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.85 / $36.92 / $83.11	Professional	26	$26.85	$36.92	$83.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $145.05 / $195.52 / $340.50	Professional	TC	$145.05	$195.52	$340.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $148.60 / $184.88 / $295.02	Professional		$148.60	$184.88	$295.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.99 / $34.44 / $76.81	Professional	26	$26.99	$34.44	$76.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $143.02 / $146.01 / $146.22	Professional	TC	$143.02	$146.01	$146.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.99 / $468.96 / $754.00	Facility		$181.99	$468.96	$754.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.91 / $42.91 / $116.36	Facility	26	$42.91	$42.91	$116.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $227.42 / $227.42 / $625.01	Facility	TC	$227.42	$227.42	$625.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.99 / $331.38 / $580.73	Professional		$197.99	$331.38	$580.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.79 / $47.13 / $86.48	Professional	26	$30.79	$47.13	$86.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $182.58 / $296.52 / $526.51	Professional	TC	$182.58	$296.52	$526.51
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $257.89 / $537.04 / $860.80	Facility		$257.89	$537.04	$860.80
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $42.02 / $42.02 / $42.02	Facility	26	$42.02	$42.02	$42.02
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $228.08 / $228.08 / $228.08	Facility	TC	$228.08	$228.08	$228.08
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $152.97 / $245.50 / $355.13	Professional		$152.97	$245.50	$355.13
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $25.22 / $36.84 / $55.15	Professional	26	$25.22	$36.84	$55.15
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $127.76 / $205.27 / $299.36	Professional	TC	$127.76	$205.27	$299.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.44 / $226.03 / $364.86	Professional		$37.44	$226.03	$364.86
United Facility/Professional Professional Modifier Low / Median / High Price $197.11 / $301.91 / $511.83	Professional		$197.11	$301.91	$511.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.77 / $40.06 / $77.16	Professional	26	$26.77	$40.06	$77.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $168.92 / $262.44 / $455.78	Professional	TC	$168.92	$262.44	$455.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $180.77 / $180.77 / $180.77	Professional		$180.77	$180.77	$180.77
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $28.09 / $28.09 / $28.09	Professional	26	$28.09	$28.09	$28.09
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $152.68 / $152.68 / $194.04	Professional	TC	$152.68	$152.68	$194.04