Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.21 / $301.30 / $762.39	Facility		$60.21	$301.30	$762.39
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.11 / $12.69 / $307.91	Facility	26	$6.11	$12.69	$307.91
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.27 / $304.80 / $604.96	Facility	TC	$25.27	$304.80	$604.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.76 / $32.65 / $116.06	Professional		$21.76	$32.65	$116.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.11 / $9.40 / $38.00	Professional	26	$6.11	$9.40	$38.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $31.72 / $68.84 / $162.00	Professional	50	$31.72	$68.84	$162.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.66 / $22.52 / $61.65	Professional	TC	$15.66	$22.52	$61.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.97 / $27.27 / $52.96	Professional		$21.97	$27.27	$52.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.62 / $9.65 / $18.48	Professional	26	$6.62	$9.65	$18.48
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $33.93 / $38.52 / $49.43	Professional	50	$33.93	$38.52	$49.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.38 / $21.85 / $46.45	Professional	TC	$18.38	$21.85	$46.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.73 / $99.23 / $163.37	Facility		$28.73	$99.23	$163.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $27.50	Facility	26	$10.36	$10.36	$27.50
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $55.70	Facility	TC	$29.08	$29.08	$55.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.47 / $33.08 / $63.71	Professional		$22.47	$33.08	$63.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.40 / $10.58 / $18.87	Professional	26	$6.40	$10.58	$18.87
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.20 / $39.20 / $39.20	Professional	50	$39.20	$39.20	$39.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.89 / $23.44 / $48.48	Professional	TC	$15.89	$23.44	$48.48
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $28.92 / $77.26 / $123.84	Facility		$28.92	$77.26	$123.84
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $10.02 / $10.02 / $10.02	Facility	26	$10.02	$10.02	$10.02
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $20.42 / $20.42 / $20.42	Facility	TC	$20.42	$20.42	$20.42
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $22.62 / $32.72 / $43.76	Professional		$22.62	$32.72	$43.76
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $6.50 / $10.23 / $13.15	Professional	26	$6.50	$10.23	$13.15
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $15.82 / $22.40 / $29.60	Professional	TC	$15.82	$22.40	$29.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.05 / $33.40 / $55.51	Professional		$14.05	$33.40	$55.51
United Facility/Professional Facility Modifier Low / Median / High Price $179.57 / $179.57 / $404.03	Facility		$179.57	$179.57	$404.03
United Facility/Professional Professional Modifier Low / Median / High Price $23.16 / $27.84 / $58.37	Professional		$23.16	$27.84	$58.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.04 / $8.61 / $17.51	Professional	26	$7.04	$8.61	$17.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.38 / $20.04 / $38.60	Professional	TC	$15.38	$20.04	$38.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $17.25 / $17.25 / $17.25	Professional		$17.25	$17.25	$17.25
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.44 / $4.44 / $4.44	Professional	26	$4.44	$4.44	$4.44
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $12.81 / $12.81 / $12.81	Professional	TC	$12.81	$12.81	$12.81