Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.95 / $245.96 / $599.26	Facility		$34.95	$245.96	$599.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.45 / $8.31 / $27.11	Facility	26	$5.45	$8.31	$27.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $14.38 / $58.56 / $332.77	Facility	TC	$14.38	$58.56	$332.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.82 / $27.77 / $58.43	Professional		$19.82	$27.77	$58.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.45 / $7.81 / $29.24	Professional	26	$5.45	$7.81	$29.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $57.60 / $64.80 / $108.21	Professional	50	$57.60	$64.80	$108.21
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.92 / $12.98 / $20.70	Professional	52	$9.92	$12.98	$20.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.38 / $20.28 / $36.49	Professional	TC	$14.38	$20.28	$36.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.71 / $23.39 / $40.47	Professional		$18.71	$23.39	$40.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.88 / $8.94 / $16.47	Professional	26	$5.88	$8.94	$16.47
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $30.69 / $32.39 / $37.03	Professional	50	$30.69	$32.39	$37.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.23 / $25.75 / $25.75	Professional	TC	$18.23	$25.75	$25.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.17 / $100.10 / $197.66	Facility		$25.17	$100.10	$197.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $24.47	Facility	26	$9.19	$9.19	$24.47
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.47 / $26.47 / $55.70	Facility	TC	$26.47	$26.47	$55.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.03 / $29.80 / $57.23	Professional		$20.03	$29.80	$57.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.70 / $9.06 / $16.43	Professional	26	$5.70	$9.06	$16.43
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $37.85 / $37.85 / $37.85	Professional	50	$37.85	$37.85	$37.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.68 / $21.18 / $42.83	Professional	TC	$14.68	$21.18	$42.83
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $26.14 / $66.34 / $106.33	Facility		$26.14	$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 $18.57 / $18.57 / $18.57	Facility	TC	$18.57	$18.57	$18.57
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $20.46 / $29.51 / $39.56	Professional		$20.46	$29.51	$39.56
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $5.82 / $9.33 / $11.74	Professional	26	$5.82	$9.33	$11.74
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $14.16 / $19.97 / $26.94	Professional	TC	$14.16	$19.97	$26.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.76 / $33.21 / $55.11	Professional		$12.76	$33.21	$55.11
United Facility/Professional Facility Modifier Low / Median / High Price $45.95 / $252.18 / $567.40	Facility		$45.95	$252.18	$567.40
United Facility/Professional Professional Modifier Low / Median / High Price $20.74 / $25.66 / $53.18	Professional		$20.74	$25.66	$53.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.15 / $7.24 / $15.20	Professional	26	$6.15	$7.24	$15.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.26 / $17.97 / $37.60	Professional	TC	$14.26	$17.97	$37.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $15.57 / $15.57 / $15.57	Professional		$15.57	$15.57	$15.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $3.93 / $3.93 / $3.93	Professional	26	$3.93	$3.93	$3.93
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $11.63 / $11.63 / $11.63	Professional	TC	$11.63	$11.63	$11.63