Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.78 / $531.17 / $946.85	Facility		$107.78	$531.17	$946.85
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.50 / $19.44 / $25.93	Facility	26	$17.50	$19.44	$25.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.57 / $127.43 / $235.35	Professional		$101.57	$127.43	$235.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.28 / $23.05 / $54.24	Professional	26	$18.28	$23.05	$54.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.14 / $106.95 / $167.98	Professional	TC	$84.14	$106.95	$167.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.80 / $105.11 / $275.77	Professional		$85.80	$105.11	$275.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.54 / $29.46 / $49.25	Professional	26	$16.54	$29.46	$49.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $83.33 / $83.33 / $83.33	Professional	TC	$83.33	$83.33	$83.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.52 / $228.61 / $754.00	Facility		$109.52	$228.61	$754.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.35 / $26.35 / $71.39	Facility	26	$26.35	$26.35	$71.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.63 / $198.27 / $358.60	Professional		$117.63	$198.27	$358.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.88 / $30.18 / $54.87	Professional	26	$19.88	$30.18	$54.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.95 / $176.58 / $312.39	Professional	TC	$108.95	$176.58	$312.39
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $155.19 / $358.67 / $574.88	Facility		$155.19	$358.67	$574.88
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $26.23 / $26.23 / $26.23	Facility	26	$26.23	$26.23	$26.23
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $91.97 / $145.16 / $219.57	Professional		$91.97	$145.16	$219.57
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $15.42 / $23.68 / $34.10	Professional	26	$15.42	$23.68	$34.10
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $76.55 / $120.38 / $183.41	Professional	TC	$76.55	$120.38	$183.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $121.71 / $195.50	Professional		$36.17	$121.71	$195.50
United Facility/Professional Professional Modifier Low / Median / High Price $120.43 / $182.32 / $308.70	Professional		$120.43	$182.32	$308.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.50 / $25.27 / $48.37	Professional	26	$17.50	$25.27	$48.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.24 / $156.04 / $268.73	Professional	TC	$99.24	$156.04	$268.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $108.51 / $108.51 / $108.51	Professional		$108.51	$108.51	$108.51
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $17.11 / $17.11 / $17.11	Professional	26	$17.11	$17.11	$17.11
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $91.40 / $91.40 / $106.96	Professional	TC	$91.40	$91.40	$106.96