Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $149.00 / $154.96 / $169.24	Facility	26	$149.00	$154.96	$169.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.71 / $295.77 / $408.96	Professional		$255.71	$295.77	$408.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $156.71 / $188.30 / $273.61	Professional	26	$156.71	$188.30	$273.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.36 / $112.30 / $157.63	Professional	TC	$91.36	$112.30	$157.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $249.48 / $278.87 / $468.94	Professional		$249.48	$278.87	$468.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $173.79 / $228.92 / $334.63	Professional	26	$173.79	$228.92	$334.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $208.62 / $208.62 / $208.62	Facility	26	$208.62	$208.62	$208.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.60 / $365.41 / $647.51	Professional		$117.60	$365.41	$647.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $159.97 / $251.56 / $449.49	Professional	26	$159.97	$251.56	$449.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.32 / $147.02 / $277.52	Professional	TC	$88.32	$147.02	$277.52
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $140.08 / $223.10 / $342.96	Professional		$140.08	$223.10	$342.96
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $83.95 / $140.87 / $210.18	Professional	26	$83.95	$140.87	$210.18
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $56.13 / $81.02 / $127.57	Professional	TC	$56.13	$81.02	$127.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.77 / $216.38 / $392.16	Professional		$95.77	$216.38	$392.16
United Facility/Professional Professional Modifier Low / Median / High Price $232.20 / $331.93 / $577.97	Professional		$232.20	$331.93	$577.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $144.81 / $206.59 / $368.50	Professional	26	$144.81	$206.59	$368.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.73 / $123.82 / $221.14	Professional	TC	$85.73	$123.82	$221.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $217.03 / $217.03 / $257.66	Professional		$217.03	$217.03	$257.66
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $139.91 / $139.91 / $164.28	Professional	26	$139.91	$139.91	$164.28
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $77.11 / $77.11 / $97.99	Professional	TC	$77.11	$77.11	$97.99