Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.05 / $269.36 / $772.94	Facility		$58.05	$269.36	$772.94
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.11 / $10.88 / $31.43	Facility	26	$6.11	$10.88	$31.43
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.48 / $127.84 / $500.04	Facility	TC	$19.48	$127.84	$500.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.60 / $38.32 / $114.06	Professional		$25.60	$38.32	$114.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.11 / $9.32 / $42.00	Professional	26	$6.11	$9.32	$42.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $59.69 / $133.22 / $307.80	Professional	50	$59.69	$133.22	$307.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.80 / $16.62 / $24.42	Professional	52	$12.80	$16.62	$24.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $28.01 / $63.14	Professional	TC	$19.48	$28.01	$63.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.59 / $31.92 / $56.69	Professional		$24.59	$31.92	$56.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.69 / $8.57 / $18.48	Professional	26	$6.69	$8.57	$18.48
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $39.68 / $45.34 / $52.67	Professional	50	$39.68	$45.34	$52.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.37 / $23.58 / $43.29	Professional	TC	$22.37	$23.58	$43.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.19 / $100.10 / $163.37	Facility		$29.19	$100.10	$163.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $27.50	Facility	26	$10.36	$10.36	$27.50
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.79 / $35.79 / $73.45	Facility	TC	$35.79	$35.79	$73.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.75 / $37.19 / $73.26	Professional		$26.75	$37.19	$73.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.40 / $10.54 / $18.87	Professional	26	$6.40	$10.54	$18.87
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $48.26 / $48.26 / $48.26	Professional	50	$48.26	$48.26	$48.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.97 / $28.75 / $58.10	Professional	TC	$19.97	$28.75	$58.10
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $35.46 / $77.26 / $123.84	Facility		$35.46	$77.26	$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 $27.38 / $27.38 / $27.38	Facility	TC	$27.38	$27.38	$27.38
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $26.45 / $37.40 / $51.65	Professional		$26.45	$37.40	$51.65
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $6.50 / $10.52 / $13.15	Professional	26	$6.50	$10.52	$13.15
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $20.18 / $26.41 / $39.70	Professional	TC	$20.18	$26.41	$39.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.75 / $33.46 / $55.74	Professional		$17.75	$33.46	$55.74
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 $26.56 / $32.39 / $68.81	Professional		$26.56	$32.39	$68.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.05 / $8.57 / $17.12	Professional	26	$7.05	$8.57	$17.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $24.34 / $50.16	Professional	TC	$19.05	$24.34	$50.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.25 / $21.25 / $21.25	Professional		$21.25	$21.25	$21.25
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.67 / $4.67 / $4.67	Professional	26	$4.67	$4.67	$4.67
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.59 / $16.59 / $16.59	Professional	TC	$16.59	$16.59	$16.59