Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $269.15 / $724.44	Facility		$39.81	$269.15	$724.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.25 / $6.17 / $23.99	Facility	26	$5.25	$6.17	$23.99
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $13.18 / $85.11 / $288.40	Facility	TC	$13.18	$85.11	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $28.84 / $79.43	Professional		$10.72	$28.84	$79.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.96 / $38.02	Professional	26	$6.03	$10.96	$38.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.49 / $58.88 / $251.19	Professional	50	$15.49	$58.88	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $21.88 / $47.86	Professional	TC	$14.13	$21.88	$47.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $23.99 / $48.98	Professional		$18.62	$23.99	$48.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $7.94 / $12.59	Professional	26	$5.75	$7.94	$12.59
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $21.38 / $36.31	Professional	TC	$13.80	$21.38	$36.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $104.71 / $177.83	Facility		$45.71	$104.71	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $15.14	Facility	26	$1.86	$8.71	$15.14
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.01 / $23.44 / $33.88	Facility	TC	$5.01	$23.44	$33.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $27.54 / $56.23	Professional		$19.50	$27.54	$56.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.50 / $8.71 / $17.78	Professional	26	$5.50	$8.71	$17.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $20.42 / $43.65	Professional	TC	$13.80	$20.42	$43.65
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $60.26 / $112.20	Facility		$19.95	$60.26	$112.20
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $8.91 / $8.91	Facility	26	$8.91	$8.91	$8.91
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $18.20 / $18.20 / $18.20	Facility	TC	$18.20	$18.20	$18.20
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $25.70 / $38.90	Professional		$19.95	$25.70	$38.90
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $5.37 / $7.76 / $11.22	Professional	26	$5.37	$7.76	$11.22
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $16.98 / $26.30	Professional	TC	$13.80	$16.98	$26.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.13 / $19.50 / $33.11	Professional		$5.13	$19.50	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $64.57 / $144.54	Facility		$12.02	$64.57	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $25.12 / $45.71	Professional		$20.42	$25.12	$45.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $7.41 / $13.80	Professional	26	$6.17	$7.41	$13.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $17.78 / $31.62	Professional	TC	$14.45	$17.78	$31.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $16.98 / $28.18	Professional		$16.98	$16.98	$28.18
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.47 / $4.47 / $7.76	Professional	26	$4.47	$4.47	$7.76
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $12.59 / $20.42	Professional	TC	$12.59	$12.59	$20.42