Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.48 / $213.10 / $652.83	Facility		$31.48	$213.10	$652.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.45 / $9.27 / $75.20	Facility	26	$5.45	$9.27	$75.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $13.10 / $53.59 / $349.61	Facility	TC	$13.10	$53.59	$349.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.55 / $27.50 / $68.31	Professional		$18.55	$27.50	$68.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.45 / $7.89 / $27.90	Professional	26	$5.45	$7.89	$27.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $54.26 / $111.50 / $115.38	Professional	50	$54.26	$111.50	$115.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.10 / $19.20 / $38.31	Professional	TC	$13.10	$19.20	$38.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.54 / $23.13 / $44.93	Professional		$17.54	$23.13	$44.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.48 / $8.56 / $16.47	Professional	26	$4.48	$8.56	$16.47
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $34.63 / $34.63 / $42.54	Professional	50	$34.63	$34.63	$42.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.35 / $15.65 / $29.27	Professional	TC	$13.35	$15.65	$29.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.50 / $99.23 / $163.37	Facility		$25.50	$99.23	$163.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $23.47	Facility	26	$9.19	$9.19	$23.47
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.86 / $23.86 / $53.70	Facility	TC	$23.86	$23.86	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.09 / $29.71 / $56.36	Professional		$20.09	$29.71	$56.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.70 / $8.81 / $16.12	Professional	26	$5.70	$8.81	$16.12
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.11 / $35.11 / $35.11	Professional	50	$35.11	$35.11	$35.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.39 / $21.57 / $41.69	Professional	TC	$14.39	$21.57	$41.69
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $27.20 / $70.17 / $112.47	Facility		$27.20	$70.17	$112.47
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 $20.05 / $20.05 / $20.05	Facility	TC	$20.05	$20.05	$20.05
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $20.56 / $29.88 / $37.58	Professional		$20.56	$29.88	$37.58
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $5.82 / $8.68 / $11.26	Professional	26	$5.82	$8.68	$11.26
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $14.37 / $21.20 / $27.17	Professional	TC	$14.37	$21.20	$27.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.97 / $33.21 / $55.11	Professional		$12.97	$33.21	$55.11
United Facility/Professional Facility Modifier Low / Median / High Price $7.84 / $22.40 / $179.57	Facility		$7.84	$22.40	$179.57
United Facility/Professional Professional Modifier Low / Median / High Price $20.97 / $24.00 / $49.19	Professional		$20.97	$24.00	$49.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.85 / $7.18 / $14.28	Professional	26	$5.85	$7.18	$14.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.66 / $17.05 / $36.17	Professional	TC	$14.66	$17.05	$36.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $16.21 / $16.21 / $16.21	Professional		$16.21	$16.21	$16.21
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.42 / $4.42 / $4.42	Professional	26	$4.42	$4.42	$4.42
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $11.79 / $11.79 / $11.79	Professional	TC	$11.79	$11.79	$11.79