Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $302.00 / $676.08	Facility		$40.74	$302.00	$676.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $8.32 / $33.11	Facility	26	$7.08	$8.32	$33.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.05 / $58.88 / $281.84	Facility	TC	$19.05	$58.88	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $47.86 / $102.33	Professional		$27.54	$47.86	$102.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $14.13 / $32.36	Professional	26	$7.41	$14.13	$32.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $79.43 / $194.98	Professional	50	$38.02	$79.43	$194.98
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.78 / $147.91 / $162.18	Professional	52	$17.78	$147.91	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.20 / $61.66	Professional	TC	$19.95	$30.20	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $33.88 / $61.66	Professional		$26.30	$33.88	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.47 / $17.78	Professional	26	$7.94	$10.47	$17.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.84 / $38.90	Professional	TC	$19.05	$28.84	$38.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $245.47 / $363.08	Facility		$64.57	$245.47	$363.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $20.89	Facility	26	$2.63	$12.30	$20.89
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $7.08 / $33.11 / $47.86	Facility	TC	$7.08	$33.11	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $40.74 / $81.28	Professional		$28.18	$40.74	$81.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $12.30 / $24.55	Professional	26	$7.59	$12.30	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $29.51 / $61.66	Professional	TC	$19.95	$29.51	$61.66
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $87.10 / $144.54	Facility		$41.69	$87.10	$144.54
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $29.51 / $29.51 / $29.51	Facility	TC	$29.51	$29.51	$29.51
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $36.31 / $57.54	Professional		$28.18	$36.31	$57.54
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.72 / $15.85	Professional	26	$7.59	$10.72	$15.85
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $25.70 / $40.74	Professional	TC	$20.89	$25.70	$40.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.24 / $28.18 / $45.71	Professional		$7.24	$28.18	$45.71
United Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $85.11 / $239.88	Facility		$16.60	$85.11	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $35.48 / $64.57	Professional		$29.51	$35.48	$64.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.23 / $19.05	Professional	26	$8.71	$10.23	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $25.12 / $45.71	Professional	TC	$20.89	$25.12	$45.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $24.55 / $40.74	Professional		$24.55	$24.55	$40.74
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $6.31 / $10.72	Professional	26	$6.31	$6.31	$10.72
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $18.20 / $30.20	Professional	TC	$18.20	$18.20	$30.20