Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $295.12 / $660.69	Facility		$38.02	$295.12	$660.69
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $8.71 / $30.20	Facility	26	$5.62	$8.71	$30.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $14.79 / $134.90 / $436.52	Facility	TC	$14.79	$134.90	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $34.67 / $104.71	Professional		$11.22	$34.67	$104.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $11.75 / $37.15	Professional	26	$6.61	$11.75	$37.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.88 / $102.33 / $186.21	Professional	50	$33.88	$102.33	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $28.18 / $63.10	Professional	TC	$15.85	$28.18	$63.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $26.92 / $52.48	Professional		$20.89	$26.92	$52.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $8.32 / $14.13	Professional	26	$6.31	$8.32	$14.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $30.20 / $36.31 / $63.10	Professional	50	$30.20	$36.31	$63.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $21.38 / $41.69	Professional	TC	$15.14	$21.38	$41.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $104.71 / $177.83	Facility		$44.67	$104.71	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $16.22	Facility	26	$2.04	$9.55	$16.22
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.62 / $26.30 / $38.02	Facility	TC	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $32.36 / $64.57	Professional		$22.39	$32.36	$64.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $9.33 / $19.05	Professional	26	$5.89	$9.33	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $24.55 / $50.12	Professional	TC	$16.22	$24.55	$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 $9.33 / $9.33 / $9.33	Facility	26	$9.33	$9.33	$9.33
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $23.44 / $23.44 / $23.44	Facility	TC	$23.44	$23.44	$23.44
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $29.51 / $45.71	Professional		$22.39	$29.51	$45.71
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $8.13 / $12.02	Professional	26	$5.89	$8.13	$12.02
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $20.89 / $33.11	Professional	TC	$16.60	$20.89	$33.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.89 / $23.44 / $36.31	Professional		$5.89	$23.44	$36.31
United Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $64.57 / $144.54	Facility		$13.18	$64.57	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $28.18 / $51.29	Professional		$23.99	$28.18	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $7.76 / $14.79	Professional	26	$6.61	$7.76	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $20.42 / $37.15	Professional	TC	$16.98	$20.42	$37.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $32.36	Professional		$20.42	$20.42	$32.36
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.25 / $5.25 / $8.32	Professional	26	$5.25	$5.25	$8.32
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $15.14 / $23.99	Professional	TC	$15.14	$15.14	$23.99