Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.75 / $272.88 / $703.18	Facility		$61.75	$272.88	$703.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.90 / $6.79 / $28.36	Facility	26	$5.90	$6.79	$28.36
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $11.32 / $209.82 / $439.61	Facility	TC	$11.32	$209.82	$439.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.45 / $21.51 / $53.48	Professional		$16.45	$21.51	$53.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.90 / $8.85 / $35.00	Professional	26	$5.90	$8.85	$35.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.74 / $13.52 / $24.85	Professional	TC	$9.74	$13.52	$24.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.09 / $19.64 / $25.90	Professional		$17.09	$19.64	$25.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.38 / $8.97 / $17.84	Professional	26	$6.38	$8.97	$17.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $16.45 / $136.36 / $190.89	Facility		$16.45	$136.36	$190.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $26.51	Facility	26	$9.67	$9.67	$26.51
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $19.39 / $19.39 / $30.03	Facility	TC	$19.39	$19.39	$30.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.68 / $23.52 / $46.83	Professional		$17.68	$23.52	$46.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $10.28 / $18.00	Professional	26	$6.17	$10.28	$18.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.72 / $13.91 / $28.98	Professional	TC	$9.72	$13.91	$28.98
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $32.59 / $64.70 / $102.20	Facility		$32.59	$64.70	$102.20
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $9.57 / $9.57 / $9.57	Facility	26	$9.57	$9.57	$9.57
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $11.21 / $11.21 / $11.21	Facility	TC	$11.21	$11.21	$11.21
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $15.84 / $21.56 / $30.14	Professional		$15.84	$21.56	$30.14
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $6.32 / $9.84 / $12.56	Professional	26	$6.32	$9.84	$12.56
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $8.41 / $11.89 / $16.80	Professional	TC	$8.41	$11.89	$16.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.66 / $33.21 / $55.74	Professional		$9.66	$33.21	$55.74
United Facility/Professional Facility Modifier Low / Median / High Price $62.11 / $179.57 / $404.03	Facility		$62.11	$179.57	$404.03
United Facility/Professional Professional Modifier Low / Median / High Price $15.81 / $21.35 / $45.97	Professional		$15.81	$21.35	$45.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.06 / $8.23 / $17.25	Professional	26	$7.06	$8.23	$17.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.35 / $13.20 / $25.75	Professional	TC	$8.35	$13.20	$25.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $11.99 / $11.99 / $11.99	Professional		$11.99	$11.99	$11.99
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $3.89 / $3.89 / $3.89	Professional	26	$3.89	$3.89	$3.89
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $8.10 / $8.10 / $8.10	Professional	TC	$8.10	$8.10	$8.10