Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.01 / $7.64 / $25.74	Facility	26	$5.01	$7.64	$25.74
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $8.84 / $40.56 / $321.38	Facility	TC	$8.84	$40.56	$321.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.85 / $21.21 / $37.90	Professional		$13.85	$21.21	$37.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $6.82 / $16.23	Professional	26	$5.01	$6.82	$16.23
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $59.40 / $59.40 / $108.38	Professional	50	$59.40	$59.40	$108.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.84 / $13.89 / $24.07	Professional	TC	$8.84	$13.89	$24.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.05 / $15.69 / $45.90	Professional		$13.05	$15.69	$45.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.44 / $8.40 / $13.62	Professional	26	$5.44	$8.40	$13.62
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $25.79 / $25.79 / $25.79	Professional	50	$25.79	$25.79	$25.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $9.01 / $9.01 / $19.78	Professional	TC	$9.01	$9.01	$19.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $8.46 / $23.47	Facility	26	$8.46	$8.46	$23.47
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $16.03 / $16.03 / $41.88	Facility	TC	$16.03	$16.03	$41.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.95 / $25.35 / $45.18	Professional		$14.95	$25.35	$45.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.24 / $8.64 / $15.62	Professional	26	$5.24	$8.64	$15.62
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $31.05 / $31.05 / $31.05	Professional	50	$31.05	$31.05	$31.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.71 / $16.91 / $31.01	Professional	TC	$9.71	$16.91	$31.01
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $8.58 / $8.58 / $8.58	Facility	26	$8.58	$8.58	$8.58
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $15.65 / $15.65 / $15.65	Facility	TC	$15.65	$15.65	$15.65
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $15.30 / $26.05 / $31.80	Professional		$15.30	$26.05	$31.80
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $5.36 / $8.68 / $11.26	Professional	26	$5.36	$8.68	$11.26
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $9.93 / $17.14 / $21.41	Professional	TC	$9.93	$17.14	$21.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.09 / $10.95 / $22.32	Professional		$5.09	$10.95	$22.32
United Facility/Professional Professional Modifier Low / Median / High Price $16.88 / $19.73 / $38.77	Professional		$16.88	$19.73	$38.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.84 / $6.81 / $14.03	Professional	26	$5.84	$6.81	$14.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.50 / $13.33 / $25.48	Professional	TC	$10.50	$13.33	$25.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $13.68 / $13.68 / $13.68	Professional		$13.68	$13.68	$13.68
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.63 / $4.63 / $4.63	Professional	26	$4.63	$4.63	$4.63
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $9.05 / $9.05 / $9.05	Professional	TC	$9.05	$9.05	$9.05