Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.75 / $127.44 / $138.82	Facility	26	$125.75	$127.44	$138.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.53 / $257.16 / $366.22	Professional		$220.53	$257.16	$366.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $132.22 / $158.84 / $250.15	Professional	26	$132.22	$158.84	$250.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $80.14 / $101.57 / $144.33	Professional	TC	$80.14	$101.57	$144.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.09 / $270.16 / $400.28	Professional		$213.09	$270.16	$400.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $152.58 / $200.49 / $282.27	Professional	26	$152.58	$200.49	$282.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $176.41 / $176.41 / $176.41	Facility	26	$176.41	$176.41	$176.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.79 / $316.00 / $552.39	Professional		$117.79	$316.00	$552.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.99 / $212.32 / $379.30	Professional	26	$134.99	$212.32	$379.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.01 / $133.35 / $247.55	Professional	TC	$80.01	$133.35	$247.55
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $120.90 / $192.33 / $295.77	Professional		$120.90	$192.33	$295.77
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $70.87 / $118.81 / $177.35	Professional	26	$70.87	$118.81	$177.35
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $50.03 / $70.92 / $113.70	Professional	TC	$50.03	$70.92	$113.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $93.04 / $161.92 / $296.59	Professional		$93.04	$161.92	$296.59
United Facility/Professional Professional Modifier Low / Median / High Price $196.53 / $286.61 / $504.68	Professional		$196.53	$286.61	$504.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $121.98 / $174.01 / $314.08	Professional	26	$121.98	$174.01	$314.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.51 / $114.79 / $188.08	Professional	TC	$77.51	$114.79	$188.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $185.37 / $185.37 / $222.43	Professional		$185.37	$185.37	$222.43
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $117.96 / $117.96 / $139.94	Professional	26	$117.96	$117.96	$139.94
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $67.41 / $67.41 / $85.72	Professional	TC	$67.41	$67.41	$85.72