Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.36 / $70.84 / $77.53	Facility	26	$68.36	$70.84	$77.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $322.56 / $404.33 / $577.91	Professional		$322.56	$404.33	$577.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.79 / $87.36 / $120.38	Professional	26	$71.79	$87.36	$120.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $252.63 / $326.23 / $460.53	Professional	TC	$252.63	$326.23	$460.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $342.00 / $408.96 / $797.47	Professional		$342.00	$408.96	$797.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.23 / $108.68 / $152.87	Professional	26	$80.23	$108.68	$152.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.38 / $96.38 / $96.38	Facility	26	$96.38	$96.38	$96.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.63 / $511.14 / $932.06	Professional		$309.63	$511.14	$932.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.92 / $115.92 / $206.76	Professional	26	$71.92	$115.92	$206.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.35 / $413.77 / $749.42	Professional	TC	$245.35	$413.77	$749.42
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $144.29 / $302.14 / $444.83	Professional		$144.29	$302.14	$444.83
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $39.64 / $64.86 / $98.92	Professional	26	$39.64	$64.86	$98.92
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $102.27 / $244.30 / $360.02	Professional	TC	$102.27	$244.30	$360.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.00 / $379.18 / $651.12	Professional		$97.00	$379.18	$651.12
United Facility/Professional Professional Modifier Low / Median / High Price $278.91 / $416.83 / $773.62	Professional		$278.91	$416.83	$773.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.40 / $95.75 / $178.33	Professional	26	$67.40	$95.75	$178.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $193.44 / $317.86 / $623.51	Professional	TC	$193.44	$317.86	$623.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $339.33 / $339.33 / $366.89	Professional		$339.33	$339.33	$366.89
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $64.09 / $64.09 / $69.29	Professional	26	$64.09	$64.09	$69.29
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $275.24 / $275.24 / $349.00	Professional	TC	$275.24	$275.24	$349.00