Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $269.15 / $602.56	Facility		$53.70	$269.15	$602.56
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.01 / $9.77 / $33.11	Facility	26	$5.01	$9.77	$33.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.60 / $128.82 / $251.19	Facility	TC	$16.60	$128.82	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $37.15 / $109.65	Professional		$23.99	$37.15	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $12.88 / $38.02	Professional	26	$6.03	$12.88	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.12 / $53.70	Professional	TC	$16.98	$25.12	$53.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $28.18 / $57.54	Professional		$23.44	$28.18	$57.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $11.48 / $15.85	Professional	26	$6.61	$11.48	$15.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $41.69 / $41.69	Professional	TC	$41.69	$41.69	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $104.71 / $213.80	Facility		$58.88	$104.71	$213.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.14 / $10.00 / $16.98	Facility	26	$2.14	$10.00	$16.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.31 / $29.51 / $42.66	Facility	TC	$6.31	$29.51	$42.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $35.48 / $72.44	Professional		$24.55	$35.48	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $12.02 / $23.99	Professional	26	$6.17	$12.02	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $26.30 / $54.95	Professional	TC	$17.38	$26.30	$54.95
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $72.44 / $134.90	Facility		$24.55	$72.44	$134.90
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $13.18 / $13.18	Facility	26	$13.18	$13.18	$13.18
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $24.55 / $24.55 / $24.55	Facility	TC	$24.55	$24.55	$24.55
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $33.11 / $50.12	Professional		$24.55	$33.11	$50.12
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $11.22 / $16.60	Professional	26	$6.17	$11.22	$16.60
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $21.88 / $35.48	Professional	TC	$18.20	$21.88	$35.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.61 / $26.92 / $41.69	Professional		$6.61	$26.92	$41.69
United Facility/Professional Facility Modifier Low / Median / High Price $14.79 / $85.11 / $239.88	Facility		$14.79	$85.11	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $32.36 / $58.88	Professional		$27.54	$32.36	$58.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.23 / $18.20	Professional	26	$8.32	$10.23	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $22.39 / $39.81	Professional	TC	$18.20	$22.39	$39.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $23.44 / $34.67	Professional		$23.44	$23.44	$34.67
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $5.62 / $8.71	Professional	26	$5.62	$5.62	$8.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $17.78 / $26.30	Professional	TC	$17.78	$17.78	$26.30