Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $131.83 / $199.53	Facility	26	$114.82	$131.83	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $758.58 / $1,548.82	Professional		$575.44	$758.58	$1,548.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $186.21 / $478.63	Professional	26	$114.82	$186.21	$478.63
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $181.97 / $295.12 / $1,258.93	Professional	52	$181.97	$295.12	$1,258.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $602.56 / $1,202.26	Professional	TC	$457.09	$602.56	$1,202.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $616.60 / $794.33	Professional		$537.03	$616.60	$794.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $131.83 / $213.80	Professional	26	$112.20	$131.83	$213.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $457.09 / $575.44	Professional	TC	$323.59	$457.09	$575.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $138.04 / $199.53	Facility	26	$29.51	$138.04	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $891.25 / $1,737.80	Professional		$549.54	$891.25	$1,737.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $173.78 / $331.13	Professional	26	$109.65	$173.78	$331.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $707.95 / $1,380.38	Professional	TC	$467.74	$707.95	$1,380.38
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $588.84 / $912.01	Professional		$346.74	$588.84	$912.01
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $102.33 / $186.21	Professional	26	$75.86	$102.33	$186.21
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $446.68 / $741.31	Professional	TC	$269.15	$446.68	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $436.52 / $1,071.52	Professional		$32.36	$436.52	$1,071.52
United Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $758.58 / $1,318.26	Professional		$501.19	$758.58	$1,318.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $154.88 / $275.42	Professional	26	$100.00	$154.88	$275.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $602.56 / $1,023.29	Professional	TC	$407.38	$602.56	$1,023.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $741.31	Professional		$501.19	$501.19	$741.31
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $93.33 / $125.89	Professional	26	$93.33	$93.33	$125.89
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $407.38 / $407.38 / $616.60	Professional	TC	$407.38	$407.38	$616.60