Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $275.42 / $645.65	Facility		$53.70	$275.42	$645.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.24 / $12.02 / $38.90	Facility	26	$7.24	$12.02	$38.90
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $17.78 / $134.90 / $346.74	Facility	TC	$17.78	$134.90	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $48.98 / $125.89	Professional		$26.30	$48.98	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $14.79 / $38.02	Professional	26	$7.94	$14.79	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $30.20 / $66.07	Professional	TC	$19.05	$30.20	$66.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $30.90 / $58.88	Professional		$24.55	$30.90	$58.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.47 / $17.38	Professional	26	$7.94	$10.47	$17.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $23.99 / $38.90	Professional	TC	$18.20	$23.99	$38.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $104.71 / $177.83	Facility		$61.66	$104.71	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $20.89	Facility	26	$2.63	$12.30	$20.89
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.76 / $31.62 / $44.67	Facility	TC	$6.76	$31.62	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $36.31 / $75.86	Professional		$25.70	$36.31	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.02 / $23.99	Professional	26	$7.59	$12.02	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.70 / $56.23	Professional	TC	$18.20	$25.70	$56.23
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $69.18 / $128.82	Facility		$23.99	$69.18	$128.82
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $11.75 / $11.75	Facility	26	$11.75	$11.75	$11.75
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $22.39 / $22.39 / $22.39	Facility	TC	$22.39	$22.39	$22.39
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $32.36 / $50.12	Professional		$25.70	$32.36	$50.12
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $10.47 / $15.14	Professional	26	$7.24	$10.47	$15.14
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $21.88 / $33.88	Professional	TC	$16.98	$21.88	$33.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.61 / $25.70 / $38.90	Professional		$6.61	$25.70	$38.90
United Facility/Professional Facility Modifier Low / Median / High Price $14.45 / $69.18 / $144.54	Facility		$14.45	$69.18	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $33.11 / $60.26	Professional		$26.92	$33.11	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.00 / $19.05	Professional	26	$8.32	$10.00	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $22.91 / $41.69	Professional	TC	$18.20	$22.91	$41.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $21.38 / $38.90	Professional		$21.38	$21.38	$38.90
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $5.75 / $10.23	Professional	26	$5.75	$5.75	$10.23
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $15.85 / $28.18	Professional	TC	$15.85	$15.85	$28.18