Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $221.96 / $882.33 / $1,575.46	Facility		$221.96	$882.33	$1,575.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.47 / $29.55 / $40.31	Facility	26	$27.47	$29.55	$40.31
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $124.07 / $602.65 / $1,154.76	Facility	TC	$124.07	$602.65	$1,154.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.65 / $205.65 / $688.33	Professional		$153.65	$205.65	$688.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.42 / $36.03 / $133.82	Professional	26	$29.42	$36.03	$133.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.08 / $161.41 / $286.79	Professional	TC	$124.08	$161.41	$286.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $116.19 / $144.44 / $230.67	Professional		$116.19	$144.44	$230.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.75 / $35.63 / $68.02	Professional	26	$23.75	$35.63	$68.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $111.57 / $154.11 / $176.23	Professional	TC	$111.57	$154.11	$176.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $183.86 / $468.96 / $754.00	Facility		$183.86	$468.96	$754.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.51 / $37.51 / $100.91	Facility	26	$37.51	$37.51	$100.91
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $172.98 / $172.98 / $457.78	Facility	TC	$172.98	$172.98	$457.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.56 / $258.89 / $466.35	Professional		$155.56	$258.89	$466.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.31 / $46.14 / $79.05	Professional	26	$30.31	$46.14	$79.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.88 / $224.72 / $402.81	Professional	TC	$138.88	$224.72	$402.81
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $206.67 / $594.97 / $953.63	Facility		$206.67	$594.97	$953.63
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $37.33 / $37.33 / $37.33	Facility	26	$37.33	$37.33	$37.33
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $168.72 / $168.72 / $168.72	Facility	TC	$168.72	$168.72	$168.72
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $119.61 / $205.07 / $287.18	Professional		$119.61	$205.07	$287.18
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $21.98 / $37.33 / $48.99	Professional	26	$21.98	$37.33	$48.99
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $97.63 / $170.93 / $231.30	Professional	TC	$97.63	$170.93	$231.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.24 / $189.54 / $301.30	Professional		$37.24	$189.54	$301.30
United Facility/Professional Professional Modifier Low / Median / High Price $155.60 / $242.30 / $408.74	Professional		$155.60	$242.30	$408.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.35 / $39.65 / $70.68	Professional	26	$27.35	$39.65	$70.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $126.72 / $200.94 / $332.04	Professional	TC	$126.72	$200.94	$332.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $141.19 / $141.19 / $141.19	Professional		$141.19	$141.19	$141.19
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $24.51 / $24.51 / $24.51	Professional	26	$24.51	$24.51	$24.51
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $116.68 / $116.68 / $148.28	Professional	TC	$116.68	$116.68	$148.28