Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.52 / $301.07 / $882.00	Facility		$95.52	$301.07	$882.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.04 / $20.07 / $22.16	Facility	26	$19.04	$20.07	$22.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.52 / $119.07 / $191.65	Professional		$95.52	$119.07	$191.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.07 / $22.82 / $38.27	Professional	26	$20.07	$22.82	$38.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.83 / $95.53 / $149.94	Professional	TC	$74.83	$95.53	$149.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $55.22 / $91.56 / $146.18	Professional		$55.22	$91.56	$146.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $30.78 / $41.79	Professional	26	$16.89	$30.78	$41.79
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 $27.06 / $27.06 / $73.78	Facility	26	$27.06	$27.06	$73.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.48 / $164.80 / $294.87	Professional		$102.48	$164.80	$294.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.03 / $31.55 / $56.24	Professional	26	$21.03	$31.55	$56.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.97 / $137.93 / $250.99	Professional	TC	$85.97	$137.93	$250.99
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $125.82 / $368.34 / $590.38	Facility		$125.82	$368.34	$590.38
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $27.22 / $27.22 / $27.22	Facility	26	$27.22	$27.22	$27.22
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $75.80 / $131.25 / $176.29	Professional		$75.80	$131.25	$176.29
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $15.96 / $25.52 / $35.38	Professional	26	$15.96	$25.52	$35.38
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $59.83 / $103.39 / $140.94	Professional	TC	$59.83	$103.39	$140.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $118.59 / $194.44	Professional		$36.17	$118.59	$194.44
United Facility/Professional Facility Modifier Low / Median / High Price $19.12 / $88.34 / $171.54	Facility		$19.12	$88.34	$171.54
United Facility/Professional Professional Modifier Low / Median / High Price $98.48 / $151.18 / $259.33	Professional		$98.48	$151.18	$259.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.39 / $26.29 / $50.44	Professional	26	$18.39	$26.29	$50.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.20 / $122.08 / $207.90	Professional	TC	$79.20	$122.08	$207.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.11 / $89.11 / $89.11	Professional		$89.11	$89.11	$89.11
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $17.62 / $17.62 / $17.62	Professional	26	$17.62	$17.62	$17.62
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $71.48 / $71.48 / $90.89	Professional	TC	$71.48	$71.48	$90.89