Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.93 / $306.45 / $782.46	Facility		$53.93	$306.45	$782.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.66 / $16.19 / $386.58	Facility	26	$5.66	$16.19	$386.58
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.31 / $252.80 / $544.03	Facility	TC	$21.31	$252.80	$544.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.58 / $38.44 / $114.00	Professional		$25.58	$38.44	$114.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.67 / $8.67 / $43.12	Professional	26	$5.67	$8.67	$43.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.85 / $75.00 / $129.76	Professional	50	$17.85	$75.00	$129.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.92 / $29.14 / $64.54	Professional	TC	$19.92	$29.14	$64.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.99 / $32.43 / $62.89	Professional		$24.99	$32.43	$62.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.16 / $8.44 / $17.16	Professional	26	$6.16	$8.44	$17.16
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $42.57 / $46.05 / $57.56	Professional	50	$42.57	$46.05	$57.56
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.66 / $28.10 / $59.59	Professional	TC	$23.66	$28.10	$59.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.89 / $99.23 / $163.37	Facility		$26.89	$99.23	$163.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $25.48	Facility	26	$9.61	$9.61	$25.48
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $36.90 / $36.90 / $73.45	Facility	TC	$36.90	$36.90	$73.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $36.61 / $72.31	Professional		$26.51	$36.61	$72.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.94 / $9.67 / $17.26	Professional	26	$5.94	$9.67	$17.26
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $47.36 / $47.36 / $47.36	Professional	50	$47.36	$47.36	$47.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.65 / $28.82 / $58.54	Professional	TC	$20.65	$28.82	$58.54
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $32.79 / $71.45 / $114.54	Facility		$32.79	$71.45	$114.54
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $27.75 / $27.75 / $27.75	Facility	TC	$27.75	$27.75	$27.75
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $26.86 / $36.11 / $52.50	Professional		$26.86	$36.11	$52.50
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $6.04 / $9.72 / $12.20	Professional	26	$6.04	$9.72	$12.20
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $19.72 / $26.02 / $40.24	Professional	TC	$19.72	$26.02	$40.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.75 / $33.48 / $55.74	Professional		$17.75	$33.48	$55.74
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 $25.34 / $32.10 / $68.17	Professional		$25.34	$32.10	$68.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.60 / $7.58 / $16.41	Professional	26	$6.60	$7.58	$16.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.87 / $24.63 / $48.33	Professional	TC	$18.87	$24.63	$48.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.99 / $20.99 / $20.99	Professional		$20.99	$20.99	$20.99
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.23 / $4.23 / $4.23	Professional	26	$4.23	$4.23	$4.23
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.76 / $16.76 / $16.76	Professional	TC	$16.76	$16.76	$16.76