Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.44 / $332.85 / $736.90	Facility		$66.44	$332.85	$736.90
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.66 / $16.67 / $311.05	Facility	26	$5.66	$16.67	$311.05
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.43 / $250.75 / $619.46	Facility	TC	$23.43	$250.75	$619.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.04 / $35.40 / $110.00	Professional		$23.04	$35.40	$110.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.67 / $8.63 / $41.24	Professional	26	$5.67	$8.63	$41.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.20 / $66.15 / $127.58	Professional	50	$16.20	$66.15	$127.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.36 / $25.35 / $59.50	Professional	TC	$17.36	$25.35	$59.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.22 / $29.82 / $56.93	Professional		$22.22	$29.82	$56.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.21 / $9.72 / $17.16	Professional	26	$6.21	$9.72	$17.16
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $36.47 / $41.67 / $50.51	Professional	50	$36.47	$41.67	$50.51
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.78 / $21.66 / $37.09	Professional	TC	$20.78	$21.66	$37.09
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 $32.44 / $32.44 / $64.56	Facility	TC	$32.44	$32.44	$64.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.23 / $33.72 / $65.20	Professional		$23.23	$33.72	$65.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.94 / $9.65 / $17.26	Professional	26	$5.94	$9.65	$17.26
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.28 / $43.28 / $43.28	Professional	50	$43.28	$43.28	$43.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.55 / $25.63 / $52.81	Professional	TC	$17.55	$25.63	$52.81
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $30.67 / $71.45 / $114.54	Facility		$30.67	$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 $22.98 / $22.98 / $22.98	Facility	TC	$22.98	$22.98	$22.98
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $24.31 / $33.18 / $46.40	Professional		$24.31	$33.18	$46.40
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 $17.23 / $23.02 / $33.32	Professional	TC	$17.23	$23.02	$33.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.65 / $33.44 / $55.74	Professional		$15.65	$33.44	$55.74
United Facility/Professional Facility Modifier Low / Median / High Price $45.95 / $145.62 / $179.57	Facility		$45.95	$145.62	$179.57
United Facility/Professional Professional Modifier Low / Median / High Price $23.74 / $28.91 / $61.40	Professional		$23.74	$28.91	$61.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.63 / $7.63 / $15.83	Professional	26	$6.63	$7.63	$15.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.88 / $21.44 / $44.14	Professional	TC	$16.88	$21.44	$44.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $18.32 / $18.32 / $18.32	Professional		$18.32	$18.32	$18.32
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.09 / $4.09 / $4.09	Professional	26	$4.09	$4.09	$4.09
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.23 / $14.23 / $14.23	Professional	TC	$14.23	$14.23	$14.23