Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.65 / $283.48 / $570.00	Facility		$59.65	$283.48	$570.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.35 / $33.31 / $66.84	Facility	26	$31.35	$33.31	$66.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.65 / $79.31 / $238.29	Professional		$59.65	$79.31	$238.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.29 / $47.18 / $89.47	Professional	26	$34.29	$47.18	$89.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.98 / $33.72 / $148.74	Professional	TC	$25.98	$33.72	$148.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.24 / $35.24 / $35.24	Professional		$35.24	$35.24	$35.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.76 / $58.38 / $63.94	Professional	26	$57.76	$58.38	$63.94
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.58 / $14.58 / $14.58	Professional	TC	$14.58	$14.58	$14.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.07 / $27.31 / $175.01	Facility		$26.07	$27.31	$175.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.98 / $41.98 / $41.98	Facility	26	$41.98	$41.98	$41.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.34 / $121.13 / $328.79	Professional		$59.34	$121.13	$328.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.29 / $65.27 / $136.59	Professional	26	$34.29	$65.27	$136.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.94 / $49.48 / $195.61	Professional	TC	$24.94	$49.48	$195.61
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $1,146.00 / $1,732.00 / $2,887.00	Facility		$1,146.00	$1,732.00	$2,887.00
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $42.72 / $59.82 / $177.01	Professional		$42.72	$59.82	$177.01
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $24.93 / $32.40 / $83.40	Professional	26	$24.93	$32.40	$83.40
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $17.79 / $25.24 / $100.36	Professional	TC	$17.79	$25.24	$100.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.13 / $48.51 / $87.85	Professional		$27.13	$48.51	$87.85
United Facility/Professional Facility Modifier Low / Median / High Price $366.00 / $1,954.00 / $5,259.00	Facility		$366.00	$1,954.00	$5,259.00
United Facility/Professional Professional Modifier Low / Median / High Price $53.76 / $108.05 / $294.13	Professional		$53.76	$108.05	$294.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.45 / $60.51 / $118.83	Professional	26	$31.45	$60.51	$118.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.96 / $46.81 / $175.40	Professional	TC	$22.96	$46.81	$175.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $49.02 / $49.02 / $61.03	Professional		$49.02	$49.02	$61.03
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.83 / $27.83 / $36.72	Professional	26	$27.83	$27.83	$36.72
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $21.19 / $21.19 / $27.04	Professional	TC	$21.19	$21.19	$27.04