Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.52 / $215.76 / $482.97	Facility		$40.52	$215.76	$482.97
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.66 / $8.65 / $81.63	Facility	26	$5.66	$8.65	$81.63
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $14.81 / $67.88 / $311.35	Facility	TC	$14.81	$67.88	$311.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.48 / $29.48 / $60.60	Professional		$20.48	$29.48	$60.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.67 / $7.96 / $19.34	Professional	26	$5.67	$7.96	$19.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.81 / $21.49 / $34.57	Professional	TC	$14.81	$21.49	$34.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $24.37 / $49.94	Professional		$19.50	$24.37	$49.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.16 / $8.61 / $17.16	Professional	26	$6.16	$8.61	$17.16
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.21 / $15.21 / $18.41	Professional	TC	$15.21	$15.21	$18.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.38 / $99.23 / $163.37	Facility		$28.38	$99.23	$163.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $25.48	Facility	26	$9.61	$9.61	$25.48
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.22 / $27.22 / $54.71	Facility	TC	$27.22	$27.22	$54.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.22 / $32.65 / $60.53	Professional		$21.22	$32.65	$60.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.94 / $9.65 / $17.26	Professional	26	$5.94	$9.65	$17.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.33 / $23.16 / $46.76	Professional	TC	$15.33	$23.16	$46.76
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $27.88 / $77.26 / $123.84	Facility		$27.88	$77.26	$123.84
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $20.05 / $20.05 / $20.05	Facility	TC	$20.05	$20.05	$20.05
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $21.33 / $31.87 / $41.70	Professional		$21.33	$31.87	$41.70
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $6.04 / $9.72 / $12.20	Professional	26	$6.04	$9.72	$12.20
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $15.66 / $21.80 / $29.07	Professional	TC	$15.66	$21.80	$29.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.62 / $33.26 / $55.11	Professional		$13.62	$33.26	$55.11
United Facility/Professional Professional Modifier Low / Median / High Price $22.12 / $26.61 / $56.03	Professional		$22.12	$26.61	$56.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.63 / $7.53 / $15.66	Professional	26	$6.63	$7.53	$15.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.24 / $18.61 / $37.22	Professional	TC	$15.24	$18.61	$37.22
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $16.63 / $16.63 / $16.63	Professional		$16.63	$16.63	$16.63
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.24 / $4.24 / $4.24	Professional	26	$4.24	$4.24	$4.24
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $12.39 / $12.39 / $12.39	Professional	TC	$12.39	$12.39	$12.39