Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.91 / $32.40 / $212.80	Facility	26	$30.91	$32.40	$212.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.18 / $253.58 / $374.44	Professional		$210.18	$253.58	$374.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.03 / $36.52 / $50.85	Professional	26	$32.03	$36.52	$50.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $178.15 / $215.84 / $305.68	Professional	TC	$178.15	$215.84	$305.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $205.01 / $205.01 / $234.88	Professional		$205.01	$205.01	$234.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.46 / $35.46 / $51.48	Professional	26	$35.46	$35.46	$51.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $107.09 / $107.09 / $107.09	Professional	TC	$107.09	$107.09	$107.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.98 / $42.98 / $42.98	Facility	26	$42.98	$42.98	$42.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.50 / $337.95 / $596.41	Professional		$222.50	$337.95	$596.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.00 / $52.64 / $91.44	Professional	26	$35.00	$52.64	$91.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $188.03 / $287.76 / $504.98	Professional	TC	$188.03	$287.76	$504.98
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $160.19 / $221.18 / $378.85	Professional		$160.19	$221.18	$378.85
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $26.69 / $33.71 / $60.25	Professional	26	$26.69	$33.71	$60.25
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $133.50 / $187.47 / $314.29	Professional	TC	$133.50	$187.47	$314.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.41 / $228.04 / $369.17	Professional		$38.41	$228.04	$369.17
United Facility/Professional Professional Modifier Low / Median / High Price $203.84 / $288.94 / $509.88	Professional		$203.84	$288.94	$509.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.40 / $44.85 / $79.06	Professional	26	$31.40	$44.85	$79.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.90 / $243.13 / $445.43	Professional	TC	$169.90	$243.13	$445.43
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $188.43 / $188.43 / $188.43	Professional		$188.43	$188.43	$188.43
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $28.85 / $28.85 / $28.85	Professional	26	$28.85	$28.85	$28.85
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $159.58 / $159.58 / $159.58	Professional	TC	$159.58	$159.58	$159.58