Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.75 / $110.15 / $181.34	Facility	26	$105.75	$110.15	$181.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $188.22 / $222.27 / $337.62	Professional		$188.22	$222.27	$337.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.15 / $133.88 / $224.32	Professional	26	$110.15	$133.88	$224.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.90 / $91.57 / $134.34	Professional	TC	$76.90	$91.57	$134.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $182.42 / $239.30 / $343.22	Professional		$182.42	$239.30	$343.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $126.85 / $178.18 / $223.70	Professional	26	$126.85	$178.18	$223.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.65 / $147.65 / $147.65	Facility	26	$147.65	$147.65	$147.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.79 / $274.39 / $473.81	Professional		$117.79	$274.39	$473.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.66 / $177.58 / $315.95	Professional	26	$112.66	$177.58	$315.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.06 / $121.24 / $223.78	Professional	TC	$71.06	$121.24	$223.78
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $103.24 / $164.24 / $253.40	Professional		$103.24	$164.24	$253.40
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $59.02 / $99.14 / $147.74	Professional	26	$59.02	$99.14	$147.74
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $44.23 / $63.37 / $101.36	Professional	TC	$44.23	$63.37	$101.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.56 / $149.94 / $293.14	Professional		$64.56	$149.94	$293.14
United Facility/Professional Professional Modifier Low / Median / High Price $175.23 / $245.63 / $442.04	Professional		$175.23	$245.63	$442.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.87 / $144.54 / $260.35	Professional	26	$102.87	$144.54	$260.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.53 / $102.48 / $183.93	Professional	TC	$71.53	$102.48	$183.93
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $159.07 / $159.07 / $185.56	Professional		$159.07	$159.07	$185.56
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $98.56 / $98.56 / $113.62	Professional	26	$98.56	$98.56	$113.62
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $60.51 / $60.51 / $76.76	Professional	TC	$60.51	$60.51	$76.76