Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $316.23 / $741.31	Facility		$70.79	$316.23	$741.31
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $41.69 / $67.61	Facility	26	$30.90	$41.69	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $87.10 / $338.84	Professional		$54.95	$87.10	$338.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $52.48 / $162.18	Professional	26	$33.11	$52.48	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $38.90 / $194.98	Professional	TC	$25.12	$38.90	$194.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $33.88 / $72.44	Professional		$29.51	$33.88	$72.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $51.29 / $67.61	Professional	26	$38.02	$51.29	$67.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $13.49 / $48.98	Professional	TC	$12.02	$13.49	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $26.30 / $104.71	Facility		$26.30	$26.30	$104.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $43.65 / $63.10	Facility	26	$9.33	$43.65	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $125.89 / $331.13	Professional		$63.10	$125.89	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $69.18 / $138.04	Professional	26	$35.48	$69.18	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $52.48 / $199.53	Professional	TC	$26.30	$52.48	$199.53
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,862.09 / $3,162.28	Facility		$1,258.93	$1,862.09	$3,162.28
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $63.10 / $177.83	Professional		$46.77	$63.10	$177.83
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $33.88 / $85.11	Professional	26	$26.30	$33.88	$85.11
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $26.92 / $100.00	Professional	TC	$19.95	$26.92	$100.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.11 / $93.33	Professional		$28.84	$33.11	$93.33
United Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $1,584.89 / $3,890.45	Facility		$199.53	$1,584.89	$3,890.45
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $120.23 / $288.40	Professional		$54.95	$120.23	$288.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $61.66 / $117.49	Professional	26	$31.62	$61.66	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $50.12 / $173.78	Professional	TC	$23.44	$50.12	$173.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $67.61	Professional		$48.98	$48.98	$67.61
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $27.54 / $37.15	Professional	26	$27.54	$27.54	$37.15
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $21.38 / $30.90	Professional	TC	$21.38	$21.38	$30.90