Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.57 / $5.89 / $24.55	Facility	26	$4.57	$5.89	$24.55
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.05 / $134.90 / $398.11	Facility	TC	$19.05	$134.90	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $40.74 / $97.72	Professional		$13.80	$40.74	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $9.77 / $27.54	Professional	26	$5.01	$9.77	$27.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.67 / $102.33 / $204.17	Professional	50	$34.67	$102.33	$204.17
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.38 / $33.88 / $112.20	Professional	52	$17.38	$33.88	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $32.36 / $69.18	Professional	TC	$19.05	$32.36	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $31.62 / $61.66	Professional		$24.55	$31.62	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $6.92 / $10.96	Professional	26	$5.01	$6.92	$10.96
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $44.67 / $74.13	Professional	50	$38.02	$44.67	$74.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.90 / $54.95	Professional	TC	$21.88	$30.90	$54.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.62 / $7.59 / $12.88	Facility	26	$1.62	$7.59	$12.88
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $7.41 / $34.67 / $48.98	Facility	TC	$7.41	$34.67	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $31.62 / $69.18	Professional		$22.39	$31.62	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.79 / $7.24 / $15.14	Professional	26	$4.79	$7.24	$15.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $25.70 / $58.88	Professional	TC	$17.78	$25.70	$58.88
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $7.41 / $7.41	Facility	26	$7.41	$7.41	$7.41
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $25.70 / $25.70	Facility	TC	$25.70	$25.70	$25.70
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $29.51 / $47.86	Professional		$21.88	$29.51	$47.86
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $4.68 / $6.61 / $9.77	Professional	26	$4.68	$6.61	$9.77
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $23.44 / $38.02	Professional	TC	$15.14	$23.44	$38.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $3.98 / $24.55 / $39.81	Professional		$3.98	$24.55	$39.81
United Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $29.51 / $53.70	Professional		$21.88	$29.51	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.13 / $6.17 / $11.75	Professional	26	$5.13	$6.17	$11.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $23.44 / $43.65	Professional	TC	$16.60	$23.44	$43.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $38.02	Professional		$20.42	$20.42	$38.02
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $3.55 / $3.55 / $6.76	Professional	26	$3.55	$3.55	$6.76
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $16.98 / $31.62	Professional	TC	$16.98	$16.98	$31.62