Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.51 / $252.80 / $661.16	Facility		$78.51	$252.80	$661.16
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.23 / $15.02 / $249.47	Facility	26	$7.23	$15.02	$249.47
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.60 / $205.53 / $439.61	Facility	TC	$25.60	$205.53	$439.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.40 / $42.49 / $119.25	Professional		$29.40	$42.49	$119.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $10.81 / $33.24	Professional	26	$7.23	$10.81	$33.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $31.54 / $66.38	Professional	TC	$22.26	$31.54	$66.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.72 / $37.34 / $72.53	Professional		$28.72	$37.34	$72.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.87 / $10.36 / $21.89	Professional	26	$7.87	$10.36	$21.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.53 / $31.50 / $66.75	Professional	TC	$26.53	$31.50	$66.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.31 / $144.78 / $220.96	Facility		$53.31	$144.78	$220.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $32.54	Facility	26	$12.30	$12.30	$32.54
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $41.38 / $41.38 / $84.32	Facility	TC	$41.38	$41.38	$84.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.17 / $45.75 / $87.54	Professional		$31.17	$45.75	$87.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.57 / $12.58 / $22.05	Professional	26	$7.57	$12.58	$22.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.94 / $33.28 / $66.19	Professional	TC	$22.94	$33.28	$66.19
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $41.07 / $78.41 / $123.84	Facility		$41.07	$78.41	$123.84
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $11.82 / $11.82 / $11.82	Facility	26	$11.82	$11.82	$11.82
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $31.41 / $31.41 / $31.41	Facility	TC	$31.41	$31.41	$31.41
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $31.34 / $43.72 / $60.33	Professional		$31.34	$43.72	$60.33
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $7.75 / $12.11 / $15.52	Professional	26	$7.75	$12.11	$15.52
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $23.56 / $31.61 / $45.15	Professional	TC	$23.56	$31.61	$45.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.92 / $33.62 / $57.12	Professional		$18.92	$33.62	$57.12
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 $31.27 / $37.49 / $80.72	Professional		$31.27	$37.49	$80.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $9.78 / $19.53	Professional	26	$8.66	$9.78	$19.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.77 / $27.82 / $54.54	Professional	TC	$22.77	$27.82	$54.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.63 / $24.63 / $24.63	Professional		$24.63	$24.63	$24.63
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.51 / $5.51 / $5.51	Professional	26	$5.51	$5.51	$5.51
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.12 / $19.12 / $19.12	Professional	TC	$19.12	$19.12	$19.12