Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.46 / $213.86 / $610.51	Facility		$37.46	$213.86	$610.51
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.45 / $6.85 / $26.18	Facility	26	$5.45	$6.85	$26.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.09 / $64.37 / $259.64	Facility	TC	$16.09	$64.37	$259.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.53 / $31.00 / $104.50	Professional		$21.53	$31.00	$104.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.45 / $8.25 / $25.24	Professional	26	$5.45	$8.25	$25.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.76 / $61.51 / $114.72	Professional	50	$30.76	$61.51	$114.72
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.77 / $13.97 / $20.55	Professional	52	$10.77	$13.97	$20.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.09 / $22.76 / $38.59	Professional	TC	$16.09	$22.76	$38.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.98 / $25.09 / $51.40	Professional		$19.98	$25.09	$51.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.60 / $8.09 / $16.47	Professional	26	$5.60	$8.09	$16.47
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $32.93 / $32.93 / $74.50	Professional	50	$32.93	$32.93	$74.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.04 / $18.82 / $20.05	Professional	TC	$16.04	$18.82	$20.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.63 / $99.23 / $163.37	Facility		$25.63	$99.23	$163.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $25.48	Facility	26	$9.19	$9.19	$25.48
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $63.58	Facility	TC	$29.08	$29.08	$63.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.24 / $32.52 / $61.88	Professional		$22.24	$32.52	$61.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.70 / $9.43 / $16.82	Professional	26	$5.70	$9.43	$16.82
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.47 / $41.47 / $41.47	Professional	50	$41.47	$41.47	$41.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.51 / $23.63 / $47.11	Professional	TC	$16.51	$23.63	$47.11
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $28.93 / $66.34 / $106.33	Facility		$28.93	$66.34	$106.33
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 $21.95 / $31.59 / $42.96	Professional		$21.95	$31.59	$42.96
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $5.82 / $9.39 / $11.74	Professional	26	$5.82	$9.39	$11.74
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $16.14 / $21.52 / $31.20	Professional	TC	$16.14	$21.52	$31.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.47 / $33.40 / $55.11	Professional		$14.47	$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 $21.90 / $27.24 / $56.15	Professional		$21.90	$27.24	$56.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.29 / $7.75 / $15.87	Professional	26	$6.29	$7.75	$15.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.59 / $19.98 / $40.72	Professional	TC	$15.59	$19.98	$40.72
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 $4.05 / $4.05 / $4.05	Professional	26	$4.05	$4.05	$4.05
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $13.19 / $13.19 / $13.19	Professional	TC	$13.19	$13.19	$13.19