Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.37 / $269.36 / $652.83	Facility		$56.37	$269.36	$652.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.45 / $7.63 / $26.18	Facility	26	$5.45	$7.63	$26.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $15.02 / $96.23 / $399.84	Facility	TC	$15.02	$96.23	$399.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.47 / $29.48 / $60.03	Professional		$20.47	$29.48	$60.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.45 / $7.98 / $28.81	Professional	26	$5.45	$7.98	$28.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.02 / $21.35 / $36.31	Professional	TC	$15.02	$21.35	$36.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.10 / $24.10 / $51.67	Professional		$19.10	$24.10	$51.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.70 / $7.93 / $13.89	Professional	26	$5.70	$7.93	$13.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.21 / $17.85 / $17.89	Professional	TC	$15.21	$17.85	$17.89
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 $8.86 / $8.86 / $24.47	Facility	26	$8.86	$8.86	$24.47
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.22 / $27.22 / $57.65	Facility	TC	$27.22	$27.22	$57.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.17 / $32.46 / $60.54	Professional		$21.17	$32.46	$60.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.70 / $9.67 / $16.82	Professional	26	$5.70	$9.67	$16.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.41 / $23.18 / $47.48	Professional	TC	$15.41	$23.18	$47.48
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $28.93 / $77.26 / $123.84	Facility		$28.93	$77.26	$123.84
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $8.94 / $8.94 / $8.94	Facility	26	$8.94	$8.94	$8.94
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $21.52 / $21.52 / $21.52	Facility	TC	$21.52	$21.52	$21.52
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $22.05 / $32.72 / $40.88	Professional		$22.05	$32.72	$40.88
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $5.58 / $9.39 / $11.74	Professional	26	$5.58	$9.39	$11.74
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $15.66 / $23.13 / $30.91	Professional	TC	$15.66	$23.13	$30.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.43 / $33.40 / $55.11	Professional		$14.43	$33.40	$55.11
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 $22.62 / $26.51 / $54.00	Professional		$22.62	$26.51	$54.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.51 / $7.44 / $15.26	Professional	26	$6.51	$7.44	$15.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.77 / $19.45 / $38.74	Professional	TC	$15.77	$19.45	$38.74
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 $4.13 / $4.13 / $4.13	Professional	26	$4.13	$4.13	$4.13
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $13.12 / $13.12 / $13.12	Professional	TC	$13.12	$13.12	$13.12