Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.12 / $277.94 / $618.29	Facility		$57.12	$277.94	$618.29
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.23 / $13.15 / $367.71	Facility	26	$7.23	$13.15	$367.71
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.21 / $194.52 / $414.04	Facility	TC	$19.21	$194.52	$414.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.02 / $39.14 / $98.55	Professional		$25.02	$39.14	$98.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $10.84 / $32.69	Professional	26	$7.23	$10.84	$32.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.79 / $26.42 / $50.76	Professional	TC	$17.79	$26.42	$50.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.18 / $31.25 / $60.56	Professional		$24.18	$31.25	$60.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.92 / $11.96 / $21.89	Professional	26	$7.92	$11.96	$21.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.78 / $21.66 / $26.04	Professional	TC	$20.78	$21.66	$26.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.86 / $99.23 / $163.37	Facility		$31.86	$99.23	$163.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $32.54	Facility	26	$12.30	$12.30	$32.54
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.44 / $32.44 / $61.60	Facility	TC	$32.44	$32.44	$61.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.10 / $38.00 / $72.92	Professional		$26.10	$38.00	$72.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.57 / $12.64 / $22.33	Professional	26	$7.57	$12.64	$22.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.69 / $26.49 / $54.47	Professional	TC	$18.69	$26.49	$54.47
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $32.72 / $81.13 / $130.04	Facility		$32.72	$81.13	$130.04
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $11.82 / $11.82 / $11.82	Facility	26	$11.82	$11.82	$11.82
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $22.62 / $22.62 / $22.62	Facility	TC	$22.62	$22.62	$22.62
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $25.87 / $37.33 / $49.94	Professional		$25.87	$37.33	$49.94
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $7.64 / $12.39 / $15.52	Professional	26	$7.64	$12.39	$15.52
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $17.25 / $24.32 / $32.79	Professional	TC	$17.25	$24.32	$32.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.37 / $33.21 / $55.02	Professional		$16.37	$33.21	$55.02
United Facility/Professional Facility Modifier Low / Median / High Price $45.95 / $145.62 / $179.57	Facility		$45.95	$145.62	$179.57
United Facility/Professional Professional Modifier Low / Median / High Price $26.55 / $31.69 / $66.47	Professional		$26.55	$31.69	$66.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $10.02 / $20.28	Professional	26	$8.30	$10.02	$20.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.98 / $22.56 / $44.94	Professional	TC	$17.98	$22.56	$44.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.57 / $19.57 / $19.57	Professional		$19.57	$19.57	$19.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.26 / $5.26 / $5.26	Professional	26	$5.26	$5.26	$5.26
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.31 / $14.31 / $14.31	Professional	TC	$14.31	$14.31	$14.31