Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $204.17 / $549.54	Facility		$47.86	$204.17	$549.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $8.71 / $30.20	Facility	26	$5.62	$8.71	$30.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $14.79 / $93.33 / $218.78	Facility	TC	$14.79	$93.33	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $38.02 / $104.71	Professional		$21.88	$38.02	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.72 / $28.84	Professional	26	$6.03	$10.72	$28.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $23.99 / $50.12	Professional	TC	$15.14	$23.99	$50.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $25.70 / $50.12	Professional		$20.42	$25.70	$50.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $8.51 / $14.45	Professional	26	$6.17	$8.51	$14.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $19.50 / $27.54	Professional	TC	$15.14	$19.50	$27.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $104.71 / $177.83	Facility		$51.29	$104.71	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $16.22	Facility	26	$2.04	$9.55	$16.22
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.62 / $26.30 / $38.02	Facility	TC	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $30.20 / $61.66	Professional		$21.38	$30.20	$61.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $9.33 / $19.05	Professional	26	$5.89	$9.33	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $22.39 / $47.86	Professional	TC	$15.49	$22.39	$47.86
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $66.07 / $123.03	Facility		$22.91	$66.07	$123.03
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $9.33 / $9.33	Facility	26	$9.33	$9.33	$9.33
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $19.95 / $19.95 / $19.95	Facility	TC	$19.95	$19.95	$19.95
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $27.54 / $42.66	Professional		$21.88	$27.54	$42.66
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $8.13 / $12.02	Professional	26	$5.89	$8.13	$12.02
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $18.62 / $29.51	Professional	TC	$15.14	$18.62	$29.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.50 / $20.89 / $33.11	Professional		$5.50	$20.89	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $12.59 / $64.57 / $144.54	Facility		$12.59	$64.57	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $27.54 / $48.98	Professional		$22.39	$27.54	$48.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $7.76 / $14.79	Professional	26	$6.61	$7.76	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $19.50 / $34.67	Professional	TC	$15.14	$19.50	$34.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $30.90	Professional		$18.20	$18.20	$30.90
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.68 / $4.68 / $8.32	Professional	26	$4.68	$4.68	$8.32
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $13.49 / $22.91	Professional	TC	$13.49	$13.49	$22.91