Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $281.84 / $812.83	Facility		$60.26	$281.84	$812.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.17 / $10.23 / $102.33	Facility	26	$6.17	$10.23	$102.33
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.20 / $194.98 / $616.60	Facility	TC	$18.20	$194.98	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $38.02 / $114.82	Professional		$9.33	$38.02	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.30 / $43.65	Professional	26	$7.08	$12.30	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $72.44 / $186.21	Professional	50	$34.67	$72.44	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $28.84 / $74.13	Professional	TC	$16.60	$28.84	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $28.18 / $51.29	Professional		$21.88	$28.18	$51.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $9.33 / $14.79	Professional	26	$6.76	$9.33	$14.79
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $31.62 / $39.81 / $67.61	Professional	50	$31.62	$39.81	$67.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $23.44 / $38.90	Professional	TC	$16.60	$23.44	$38.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $104.71 / $177.83	Facility		$53.70	$104.71	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $17.78	Facility	26	$2.19	$10.23	$17.78
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	TC	$6.03	$28.18	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $31.62 / $64.57	Professional		$21.88	$31.62	$64.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $10.00 / $20.42	Professional	26	$6.46	$10.00	$20.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $22.91 / $50.12	Professional	TC	$15.14	$22.91	$50.12
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 $10.00 / $10.00 / $10.00	Facility	26	$10.00	$10.00	$10.00
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 $22.91 / $28.84 / $43.65	Professional		$22.91	$28.84	$43.65
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $8.71 / $13.18	Professional	26	$6.31	$8.71	$13.18
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $19.95 / $30.90	Professional	TC	$15.14	$19.95	$30.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.50 / $21.88 / $34.67	Professional		$5.50	$21.88	$34.67
United Facility/Professional Facility Modifier Low / Median / High Price $13.80 / $69.18 / $144.54	Facility		$13.80	$69.18	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $28.84 / $51.29	Professional		$23.44	$28.84	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $8.71 / $15.85	Professional	26	$7.08	$8.71	$15.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $19.95 / $36.31	Professional	TC	$15.49	$19.95	$36.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $19.05 / $34.67	Professional		$19.05	$19.05	$34.67
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.90 / $4.90 / $8.91	Professional	26	$4.90	$4.90	$8.91
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $14.13 / $25.70	Professional	TC	$14.13	$14.13	$25.70