Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.13 / $112.06 / $159.10	Facility	26	$97.13	$112.06	$159.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $551.16 / $648.08 / $976.90	Professional		$551.16	$648.08	$976.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.42 / $128.61 / $240.87	Professional	26	$107.42	$128.61	$240.87
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $273.83 / $307.86 / $436.24	Professional	52	$273.83	$307.86	$436.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $434.27 / $518.36 / $739.38	Professional	TC	$434.27	$518.36	$739.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $540.21 / $570.44 / $697.04	Professional		$540.21	$570.44	$697.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $103.90 / $144.40 / $184.70	Professional	26	$103.90	$144.40	$184.70
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $436.31 / $436.31 / $436.31	Professional	TC	$436.31	$436.31	$436.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $133.97 / $133.97 / $133.97	Facility	26	$133.97	$133.97	$133.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $499.46 / $841.82 / $1,610.49	Professional		$499.46	$841.82	$1,610.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.27 / $167.81 / $299.61	Professional	26	$102.27	$167.81	$299.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $423.04 / $676.13 / $1,229.13	Professional	TC	$423.04	$676.13	$1,229.13
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $406.61 / $493.74 / $747.89	Professional		$406.61	$493.74	$747.89
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $78.20 / $93.52 / $186.29	Professional	26	$78.20	$93.52	$186.29
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $328.41 / $398.78 / $554.25	Professional	TC	$328.41	$398.78	$554.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $130.25 / $521.55 / $884.02	Professional		$130.25	$521.55	$884.02
United Facility/Professional Professional Modifier Low / Median / High Price $465.83 / $714.52 / $1,191.04	Professional		$465.83	$714.52	$1,191.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.36 / $147.44 / $253.78	Professional	26	$94.36	$147.44	$253.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $372.44 / $554.73 / $951.38	Professional	TC	$372.44	$554.73	$951.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $480.27 / $480.27 / $580.87	Professional		$480.27	$480.27	$580.87
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $88.60 / $88.60 / $111.72	Professional	26	$88.60	$88.60	$111.72
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $391.67 / $391.67 / $499.20	Professional	TC	$391.67	$391.67	$499.20