Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.50 / $254.10 / $694.83	Facility		$39.50	$254.10	$694.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.90 / $6.79 / $30.33	Facility	26	$5.90	$6.79	$30.33
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $16.51 / $189.98 / $381.69	Facility	TC	$16.51	$189.98	$381.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.41 / $32.02 / $107.35	Professional		$22.41	$32.02	$107.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.90 / $8.82 / $24.05	Professional	26	$5.90	$8.82	$24.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.51 / $22.83 / $43.96	Professional	TC	$16.51	$22.83	$43.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.26 / $26.58 / $54.45	Professional		$21.26	$26.58	$54.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.45 / $9.68 / $17.84	Professional	26	$6.45	$9.68	$17.84
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $40.22 / $40.22 / $40.22	Professional	50	$40.22	$40.22	$40.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.08 / $21.08 / $40.65	Professional	TC	$21.08	$21.08	$40.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.89 / $144.78 / $220.96	Facility		$39.89	$144.78	$220.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $27.50	Facility	26	$10.01	$10.01	$27.50
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $30.20 / $65.56	Facility	TC	$30.20	$30.20	$65.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.36 / $35.76 / $66.06	Professional		$24.36	$35.76	$66.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $10.53 / $18.62	Professional	26	$6.17	$10.53	$18.62
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.28 / $43.28 / $43.28	Professional	50	$43.28	$43.28	$43.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.51 / $25.41 / $50.37	Professional	TC	$17.51	$25.41	$50.37
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $39.49 / $78.41 / $123.84	Facility		$39.49	$78.41	$123.84
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $10.02 / $10.02 / $10.02	Facility	26	$10.02	$10.02	$10.02
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $24.08 / $24.08 / $24.08	Facility	TC	$24.08	$24.08	$24.08
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $24.54 / $34.51 / $45.43	Professional		$24.54	$34.51	$45.43
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $6.32 / $10.15 / $13.15	Professional	26	$6.32	$10.15	$13.15
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $17.43 / $24.21 / $34.22	Professional	TC	$17.43	$24.21	$34.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.13 / $33.44 / $55.74	Professional		$16.13	$33.44	$55.74
United Facility/Professional Facility Modifier Low / Median / High Price $179.57 / $179.57 / $179.57	Facility		$179.57	$179.57	$179.57
United Facility/Professional Professional Modifier Low / Median / High Price $24.51 / $28.62 / $59.47	Professional		$24.51	$28.62	$59.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.07 / $8.22 / $16.53	Professional	26	$7.07	$8.22	$16.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.41 / $20.86 / $42.94	Professional	TC	$17.41	$20.86	$42.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.37 / $19.37 / $19.37	Professional		$19.37	$19.37	$19.37
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.71 / $4.71 / $4.71	Professional	26	$4.71	$4.71	$4.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.66 / $14.66 / $14.66	Professional	TC	$14.66	$14.66	$14.66