Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $295.12 / $812.83	Facility		$51.29	$295.12	$812.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.17 / $7.94 / $28.18	Facility	26	$6.17	$7.94	$28.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.50 / $134.90 / $426.58	Facility	TC	$19.50	$134.90	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $43.65 / $138.04	Professional		$10.23	$43.65	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $13.80 / $47.86	Professional	26	$7.24	$13.80	$47.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $26.92 / $93.33 / $229.09	Professional	50	$26.92	$93.33	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $36.31 / $85.11	Professional	TC	$20.89	$36.31	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.11 / $57.54	Professional		$25.70	$33.11	$57.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $10.00 / $15.85	Professional	26	$6.76	$10.00	$15.85
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $47.86 / $79.43	Professional	50	$38.02	$47.86	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.18 / $45.71	Professional	TC	$20.89	$28.18	$45.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $104.71 / $177.83	Facility		$51.29	$104.71	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $17.78	Facility	26	$2.19	$10.23	$17.78
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $7.41 / $34.67 / $48.98	Facility	TC	$7.41	$34.67	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $37.15 / $77.62	Professional		$25.70	$37.15	$77.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $10.00 / $20.42	Professional	26	$6.46	$10.00	$20.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $26.92 / $61.66	Professional	TC	$19.05	$26.92	$61.66
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $66.07 / $123.03	Facility		$22.91	$66.07	$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 $27.54 / $27.54 / $27.54	Facility	TC	$27.54	$27.54	$27.54
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $33.11 / $53.70	Professional		$27.54	$33.11	$53.70
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $8.91 / $13.49	Professional	26	$6.61	$8.91	$13.49
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $24.55 / $40.74	Professional	TC	$19.95	$24.55	$40.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.89 / $26.92 / $42.66	Professional		$5.89	$26.92	$42.66
United Facility/Professional Facility Modifier Low / Median / High Price $13.80 / $69.18 / $144.54	Facility		$13.80	$69.18	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $33.11 / $60.26	Professional		$26.30	$33.11	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $8.71 / $15.85	Professional	26	$7.08	$8.71	$15.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $24.55 / $45.71	Professional	TC	$19.05	$24.55	$45.71
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $23.44 / $40.74	Professional		$23.44	$23.44	$40.74
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.13 / $5.13 / $9.33	Professional	26	$5.13	$5.13	$9.33
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $18.20 / $31.62	Professional	TC	$18.20	$18.20	$31.62