Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.13 / $12.45 / $49.74	Facility	26	$10.13	$12.45	$49.74
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.85 / $88.76 / $335.59	Facility	TC	$18.85	$88.76	$335.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.98 / $40.45 / $63.56	Professional		$28.98	$40.45	$63.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.13 / $14.25 / $21.04	Professional	26	$10.13	$14.25	$21.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.85 / $25.78 / $39.01	Professional	TC	$18.85	$25.78	$39.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.82 / $35.79 / $95.85	Professional		$29.82	$35.79	$95.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.01 / $23.19 / $32.17	Professional	26	$11.01	$23.19	$32.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $16.60 / $46.57	Facility	26	$16.60	$16.60	$46.57
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.04 / $35.04 / $71.47	Facility	TC	$35.04	$35.04	$71.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.68 / $46.34 / $84.67	Professional		$31.68	$46.34	$84.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.37 / $18.03 / $31.71	Professional	26	$10.37	$18.03	$31.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.54 / $29.18 / $56.88	Professional	TC	$20.54	$29.18	$56.88
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $16.72 / $16.72 / $16.72	Facility	26	$16.72	$16.72	$16.72
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $26.51 / $26.51 / $26.51	Facility	TC	$26.51	$26.51	$26.51
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $31.32 / $43.33 / $57.74	Professional		$31.32	$43.33	$57.74
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $10.61 / $17.16 / $21.95	Professional	26	$10.61	$17.16	$21.95
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $19.88 / $26.51 / $38.11	Professional	TC	$19.88	$26.51	$38.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.38 / $33.48 / $56.73	Professional		$19.38	$33.48	$56.73
United Facility/Professional Professional Modifier Low / Median / High Price $31.83 / $37.02 / $77.34	Professional		$31.83	$37.02	$77.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $14.12 / $28.06	Professional	26	$12.29	$14.12	$28.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.28 / $23.47 / $49.97	Professional	TC	$19.28	$23.47	$49.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.95 / $24.95 / $24.95	Professional		$24.95	$24.95	$24.95
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.83 / $7.83 / $7.83	Professional	26	$7.83	$7.83	$7.83
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.12 / $17.12 / $17.12	Professional	TC	$17.12	$17.12	$17.12