Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.25 / $82.66 / $90.79	Facility	26	$82.25	$82.66	$90.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.25 / $279.47 / $385.13	Professional		$231.25	$279.47	$385.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.34 / $100.66 / $129.52	Professional	26	$84.34	$100.66	$129.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.21 / $176.35 / $268.26	Professional	TC	$141.21	$176.35	$268.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $272.36 / $272.36 / $281.49	Professional		$272.36	$272.36	$281.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $122.97 / $122.97 / $122.97	Professional	26	$122.97	$122.97	$122.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.59 / $114.59 / $114.59	Facility	26	$114.59	$114.59	$114.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $214.35 / $364.17 / $712.53	Professional		$214.35	$364.17	$712.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.23 / $134.65 / $241.04	Professional	26	$85.23	$134.65	$241.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.32 / $228.38 / $471.02	Professional	TC	$134.32	$228.38	$471.02
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $130.51 / $205.00 / $324.66	Professional		$130.51	$205.00	$324.66
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $46.08 / $76.52 / $117.29	Professional	26	$46.08	$76.52	$117.29
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $70.26 / $134.32 / $207.24	Professional	TC	$70.26	$134.32	$207.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.91 / $213.81 / $395.30	Professional		$97.91	$213.81	$395.30
United Facility/Professional Professional Modifier Low / Median / High Price $197.33 / $285.12 / $528.66	Professional		$197.33	$285.12	$528.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.27 / $110.96 / $200.81	Professional	26	$79.27	$110.96	$200.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.47 / $173.56 / $348.46	Professional	TC	$110.47	$173.56	$348.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $222.39 / $222.39 / $243.01	Professional		$222.39	$222.39	$243.01
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $76.09 / $76.09 / $82.27	Professional	26	$76.09	$76.09	$82.27
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $146.30 / $146.30 / $185.97	Professional	TC	$146.30	$146.30	$185.97