Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $257.04 / $707.95	Facility		$45.71	$257.04	$707.95
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.89 / $6.31 / $26.92	Facility	26	$5.89	$6.31	$26.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.60 / $75.86 / $331.13	Facility	TC	$16.60	$75.86	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $33.88 / $102.33	Professional		$8.91	$33.88	$102.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.75 / $38.90	Professional	26	$7.08	$11.75	$38.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $37.15 / $134.90 / $194.98	Professional	50	$37.15	$134.90	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.70 / $60.26	Professional	TC	$16.98	$25.70	$60.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $29.51 / $52.48	Professional		$23.44	$29.51	$52.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.77 / $15.14	Professional	26	$6.46	$9.77	$15.14
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $63.10 / $63.10 / $89.13	Professional	50	$63.10	$63.10	$89.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $31.62 / $45.71	Professional	TC	$18.62	$31.62	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $165.96 / $234.42	Facility		$54.95	$165.96	$234.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.14 / $10.00 / $16.98	Facility	26	$2.14	$10.00	$16.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $6.31 / $29.51 / $41.69	Facility	TC	$6.31	$29.51	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $33.88 / $69.18	Professional		$24.55	$33.88	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $10.23 / $19.95	Professional	26	$6.17	$10.23	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.12 / $52.48	Professional	TC	$16.98	$25.12	$52.48
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $74.13 / $123.03	Facility		$33.88	$74.13	$123.03
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $10.00 / $10.00	Facility	26	$10.00	$10.00	$10.00
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $23.99 / $23.99 / $23.99	Facility	TC	$23.99	$23.99	$23.99
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $30.20 / $47.86	Professional		$24.55	$30.20	$47.86
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $8.71 / $13.18	Professional	26	$6.17	$8.71	$13.18
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $21.38 / $34.67	Professional	TC	$17.38	$21.38	$34.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.89 / $25.12 / $39.81	Professional		$5.89	$25.12	$39.81
United Facility/Professional Facility Modifier Low / Median / High Price $13.49 / $64.57 / $144.54	Facility		$13.49	$64.57	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $30.20 / $54.95	Professional		$24.55	$30.20	$54.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $8.32 / $15.49	Professional	26	$7.08	$8.32	$15.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $21.88 / $38.90	Professional	TC	$17.38	$21.88	$38.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $21.38 / $34.67	Professional		$21.38	$21.38	$34.67
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.13 / $5.13 / $8.71	Professional	26	$5.13	$5.13	$8.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $16.22 / $26.30	Professional	TC	$16.22	$16.22	$26.30