Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.80 / $88.25 / $169.76	Facility	26	$84.80	$88.25	$169.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $156.72 / $185.67 / $287.63	Professional		$156.72	$185.67	$287.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.25 / $106.83 / $177.43	Professional	26	$88.25	$106.83	$177.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.08 / $79.31 / $121.60	Professional	TC	$67.08	$79.31	$121.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.63 / $205.94 / $285.57	Professional		$151.63	$205.94	$285.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $98.80 / $133.69 / $164.70	Professional	26	$98.80	$133.69	$164.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.19 / $118.19 / $118.19	Facility	26	$118.19	$118.19	$118.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.60 / $229.22 / $394.58	Professional		$117.60	$229.22	$394.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.28 / $142.47 / $253.14	Professional	26	$90.28	$142.47	$253.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.10 / $105.67 / $192.50	Professional	TC	$62.10	$105.67	$192.50
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $85.27 / $135.74 / $209.28	Professional		$85.27	$135.74	$209.28
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $47.30 / $79.22 / $118.36	Professional	26	$47.30	$79.22	$118.36
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $37.97 / $56.19 / $89.74	Professional	TC	$37.97	$56.19	$89.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.11 / $117.80 / $213.65	Professional		$63.11	$117.80	$213.65
United Facility/Professional Professional Modifier Low / Median / High Price $142.91 / $202.09 / $372.38	Professional		$142.91	$202.09	$372.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.88 / $115.90 / $212.36	Professional	26	$82.88	$115.90	$212.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.13 / $90.45 / $152.51	Professional	TC	$63.13	$90.45	$152.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $132.51 / $132.51 / $157.09	Professional		$132.51	$132.51	$157.09
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $78.89 / $78.89 / $92.34	Professional	26	$78.89	$78.89	$92.34
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $53.62 / $53.62 / $68.04	Professional	TC	$53.62	$53.62	$68.04