Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $394.26 / $394.26 / $394.26	Facility	26	$394.26	$394.26	$394.26
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $952.19 / $952.19 / $952.19	Facility	TC	$952.19	$952.19	$952.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $299.45 / $436.78 / $773.34	Professional		$299.45	$436.78	$773.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.49 / $173.56 / $325.26	Professional	26	$134.49	$173.56	$325.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $157.18 / $236.23 / $490.76	Professional	TC	$157.18	$236.23	$490.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $170.88 / $182.62 / $256.33	Professional		$170.88	$182.62	$256.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.37 / $198.54 / $270.01	Professional	26	$82.37	$198.54	$270.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.16 / $326.16 / $326.16	Professional		$326.16	$326.16	$326.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $153.56 / $153.56 / $153.56	Professional	26	$153.56	$153.56	$153.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.60 / $172.60 / $172.60	Professional	TC	$172.60	$172.60	$172.60
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $341.77 / $512.65 / $1,156.96	Professional		$341.77	$512.65	$1,156.96
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $132.22 / $196.71 / $247.10	Professional	26	$132.22	$196.71	$247.10
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $177.03 / $319.56 / $804.88	Professional	TC	$177.03	$319.56	$804.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $176.80 / $252.13 / $453.08	Professional		$176.80	$252.13	$453.08
United Facility/Professional Professional Modifier Low / Median / High Price $189.64 / $316.58 / $843.98	Professional		$189.64	$316.58	$843.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.43 / $112.57 / $371.00	Professional	26	$84.43	$112.57	$371.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.47 / $178.64 / $454.49	Professional	TC	$92.47	$178.64	$454.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $173.81 / $173.81 / $173.81	Professional		$173.81	$173.81	$173.81
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $74.73 / $74.73 / $74.73	Professional	26	$74.73	$74.73	$74.73
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $99.07 / $99.07 / $99.07	Professional	TC	$99.07	$99.07	$99.07