Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.77 / $269.36 / $726.42	Facility		$37.77	$269.36	$726.42
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.23 / $6.57 / $26.18	Facility	26	$5.23	$6.57	$26.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $13.32 / $61.06 / $399.84	Facility	TC	$13.32	$61.06	$399.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.55 / $27.82 / $60.10	Professional		$18.55	$27.82	$60.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.23 / $7.82 / $33.60	Professional	26	$5.23	$7.82	$33.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.98 / $42.98 / $42.98	Professional	50	$42.98	$42.98	$42.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.32 / $19.46 / $36.59	Professional	TC	$13.32	$19.46	$36.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.54 / $23.13 / $47.47	Professional		$17.54	$23.13	$47.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.67 / $7.93 / $16.47	Professional	26	$5.67	$7.93	$16.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.20 / $99.23 / $163.37	Facility		$26.20	$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 $24.24 / $24.24 / $48.79	Facility	TC	$24.24	$24.24	$48.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.98 / $29.64 / $55.69	Professional		$19.98	$29.64	$55.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.48 / $9.01 / $16.37	Professional	26	$5.48	$9.01	$16.37
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.49 / $36.49 / $36.49	Professional	50	$36.49	$36.49	$36.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.36 / $20.95 / $42.33	Professional	TC	$14.36	$20.95	$42.33
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $25.80 / $70.17 / $112.47	Facility		$25.80	$70.17	$112.47
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 $18.22 / $18.22 / $18.22	Facility	TC	$18.22	$18.22	$18.22
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $19.69 / $29.20 / $37.56	Professional		$19.69	$29.20	$37.56
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $5.58 / $9.27 / $11.74	Professional	26	$5.58	$9.27	$11.74
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $13.95 / $19.82 / $26.42	Professional	TC	$13.95	$19.82	$26.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.49 / $33.21 / $55.11	Professional		$12.49	$33.21	$55.11
United Facility/Professional Facility Modifier Low / Median / High Price $45.95 / $179.57 / $404.03	Facility		$45.95	$179.57	$404.03
United Facility/Professional Professional Modifier Low / Median / High Price $20.46 / $25.23 / $53.74	Professional		$20.46	$25.23	$53.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.16 / $7.31 / $14.72	Professional	26	$6.16	$7.31	$14.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.96 / $17.48 / $35.57	Professional	TC	$13.96	$17.48	$35.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $15.37 / $15.37 / $15.37	Professional		$15.37	$15.37	$15.37
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.01 / $4.01 / $4.01	Professional	26	$4.01	$4.01	$4.01
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $11.35 / $11.35 / $11.35	Professional	TC	$11.35	$11.35	$11.35