Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.54 / $7.60 / $242.39	Facility	26	$4.54	$7.60	$242.39
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.07 / $128.91 / $419.94	Facility	TC	$19.07	$128.91	$419.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.62 / $34.46 / $91.46	Professional		$23.62	$34.46	$91.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.55 / $6.62 / $24.94	Professional	26	$4.55	$6.62	$24.94
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $34.65 / $63.75 / $287.55	Professional	50	$34.65	$63.75	$287.55
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.81 / $15.29 / $22.03	Professional	52	$11.81	$15.29	$22.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.07 / $26.59 / $55.85	Professional	TC	$19.07	$26.59	$55.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.76 / $30.11 / $58.29	Professional		$22.76	$30.11	$58.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.92 / $6.71 / $12.07	Professional	26	$4.92	$6.71	$12.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $26.96 / $57.20	Professional	TC	$23.23	$26.96	$57.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.66 / $7.66 / $20.47	Facility	26	$7.66	$7.66	$20.47
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.40 / $35.40 / $70.48	Facility	TC	$35.40	$35.40	$70.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.58 / $33.03 / $66.80	Professional		$22.58	$33.03	$66.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.76 / $7.54 / $13.74	Professional	26	$4.76	$7.54	$13.74
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.71 / $43.71 / $43.71	Professional	50	$43.71	$43.71	$43.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $25.87 / $53.93	Professional	TC	$18.32	$25.87	$53.93
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $7.49 / $7.49 / $7.49	Facility	26	$7.49	$7.49	$7.49
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $25.55 / $25.55 / $25.55	Facility	TC	$25.55	$25.55	$25.55
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $23.13 / $32.00 / $47.50	Professional		$23.13	$32.00	$47.50
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $4.70 / $7.80 / $9.83	Professional	26	$4.70	$7.80	$9.83
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $15.90 / $23.96 / $37.04	Professional	TC	$15.90	$23.96	$37.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.47 / $33.44 / $55.57	Professional		$16.47	$33.44	$55.57
United Facility/Professional Professional Modifier Low / Median / High Price $22.04 / $29.50 / $59.76	Professional		$22.04	$29.50	$59.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.03 / $6.03 / $12.29	Professional	26	$5.03	$6.03	$12.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.44 / $23.47 / $45.21	Professional	TC	$16.44	$23.47	$45.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $18.72 / $18.72 / $18.72	Professional		$18.72	$18.72	$18.72
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $3.26 / $3.26 / $3.26	Professional	26	$3.26	$3.26	$3.26
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $15.47 / $15.47 / $15.47	Professional	TC	$15.47	$15.47	$15.47