Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.10 / $54.34 / $80.80	Facility	26	$47.10	$54.34	$80.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.94 / $428.04 / $637.48	Professional		$338.94	$428.04	$637.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.71 / $60.54 / $95.09	Professional	26	$51.71	$60.54	$95.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $291.30 / $369.41 / $532.98	Professional	TC	$291.30	$369.41	$532.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $376.99 / $413.13 / $708.76	Professional		$376.99	$413.13	$708.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.31 / $50.31 / $65.81	Professional	26	$50.31	$50.31	$65.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $326.68 / $326.68 / $326.68	Professional	TC	$326.68	$326.68	$326.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.81 / $64.81 / $64.81	Facility	26	$64.81	$64.81	$64.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $342.46 / $564.04 / $1,055.41	Professional		$342.46	$564.04	$1,055.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.14 / $83.08 / $151.29	Professional	26	$49.14	$83.08	$151.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $295.47 / $483.92 / $894.81	Professional	TC	$295.47	$483.92	$894.81
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $283.76 / $323.22 / $486.44	Professional		$283.76	$323.22	$486.44
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $37.86 / $45.33 / $101.86	Professional	26	$37.86	$45.33	$101.86
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $245.89 / $265.27 / $387.56	Professional	TC	$245.89	$265.27	$387.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.13 / $417.07 / $646.47	Professional		$42.13	$417.07	$646.47
United Facility/Professional Professional Modifier Low / Median / High Price $316.36 / $491.86 / $864.20	Professional		$316.36	$491.86	$864.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.44 / $74.61 / $129.63	Professional	26	$45.44	$74.61	$129.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $268.23 / $399.80 / $715.29	Professional	TC	$268.23	$399.80	$715.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $336.01 / $336.01 / $405.37	Professional		$336.01	$336.01	$405.37
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $42.89 / $42.89 / $52.00	Professional	26	$42.89	$42.89	$52.00
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $293.12 / $293.12 / $373.84	Professional	TC	$293.12	$293.12	$373.84