Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.21 / $47.29 / $84.20	Facility	26	$46.21	$47.29	$84.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.23 / $278.02 / $1,040.61	Professional		$216.23	$278.02	$1,040.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.65 / $77.97 / $284.57	Professional	26	$49.65	$77.97	$284.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.63 / $201.10 / $346.55	Professional	TC	$151.63	$201.10	$346.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $168.53 / $204.15 / $509.56	Professional		$168.53	$204.15	$509.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.47 / $54.67 / $100.58	Professional	26	$40.47	$54.67	$100.58
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $148.06 / $151.36 / $181.34	Professional	TC	$148.06	$151.36	$181.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.58 / $62.58 / $169.82	Facility	26	$62.58	$62.58	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.08 / $384.20 / $704.56	Professional		$233.08	$384.20	$704.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.11 / $88.98 / $161.77	Professional	26	$52.11	$88.98	$161.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $192.51 / $308.31 / $540.58	Professional	TC	$192.51	$308.31	$540.58
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $62.22 / $62.22 / $62.22	Facility	26	$62.22	$62.22	$62.22
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $169.24 / $297.35 / $410.74	Professional		$169.24	$297.35	$410.74
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $39.47 / $70.77 / $99.05	Professional	26	$39.47	$70.77	$99.05
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $132.22 / $217.94 / $318.50	Professional	TC	$132.22	$217.94	$318.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $241.52 / $392.26	Professional		$41.40	$241.52	$392.26
United Facility/Professional Professional Modifier Low / Median / High Price $227.39 / $347.56 / $595.35	Professional		$227.39	$347.56	$595.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.28 / $80.73 / $143.28	Professional	26	$49.28	$80.73	$143.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $176.27 / $269.38 / $444.52	Professional	TC	$176.27	$269.38	$444.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $199.41 / $199.41 / $199.41	Professional		$199.41	$199.41	$199.41
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $41.36 / $41.36 / $41.36	Professional	26	$41.36	$41.36	$41.36
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $158.05 / $158.05 / $200.82	Professional	TC	$158.05	$158.05	$200.82