Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.38 / $313.48 / $574.91	Facility		$51.38	$313.48	$574.91
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.90 / $10.50 / $33.61	Facility	26	$5.90	$10.50	$33.61
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.72 / $68.52 / $343.69	Facility	TC	$16.72	$68.52	$343.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.62 / $33.51 / $72.18	Professional		$22.62	$33.51	$72.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.90 / $9.39 / $23.40	Professional	26	$5.90	$9.39	$23.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.72 / $23.38 / $38.17	Professional	TC	$16.72	$23.38	$38.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.46 / $28.30 / $54.96	Professional		$21.46	$28.30	$54.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.45 / $8.97 / $15.67	Professional	26	$6.45	$8.97	$15.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.25 / $100.13 / $197.66	Facility		$33.25	$100.13	$197.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $36.51	Facility	26	$10.01	$10.01	$36.51
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.58 / $30.58 / $66.55	Facility	TC	$30.58	$30.58	$66.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.58 / $39.42 / $73.01	Professional		$24.58	$39.42	$73.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $12.58 / $22.55	Professional	26	$6.17	$12.58	$22.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.16 / $26.89 / $52.48	Professional	TC	$18.16	$26.89	$52.48
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $35.83 / $83.71 / $134.16	Facility		$35.83	$83.71	$134.16
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $13.27 / $13.27 / $13.27	Facility	26	$13.27	$13.27	$13.27
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $24.45 / $24.45 / $24.45	Facility	TC	$24.45	$24.45	$24.45
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $25.15 / $38.86 / $49.51	Professional		$25.15	$38.86	$49.51
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $6.27 / $12.94 / $17.42	Professional	26	$6.27	$12.94	$17.42
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $25.15 / $34.65	Professional	TC	$17.57	$25.15	$34.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.75 / $33.48 / $55.74	Professional		$17.75	$33.48	$55.74
United Facility/Professional Facility Modifier Low / Median / High Price $124.03 / $128.80 / $567.40	Facility		$124.03	$128.80	$567.40
United Facility/Professional Professional Modifier Low / Median / High Price $27.27 / $30.54 / $61.86	Professional		$27.27	$30.54	$61.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.33 / $10.30 / $19.14	Professional	26	$8.33	$10.30	$19.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.07 / $22.47 / $43.26	Professional	TC	$18.07	$22.47	$43.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.46 / $21.46 / $21.46	Professional		$21.46	$21.46	$21.46
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.12 / $5.12 / $5.12	Professional	26	$5.12	$5.12	$5.12
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.34 / $16.34 / $16.34	Professional	TC	$16.34	$16.34	$16.34