Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.24 / $12.02 / $38.90	Facility	26	$7.24	$12.02	$38.90
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.44 / $199.53 / $630.96	Facility	TC	$23.44	$199.53	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $52.48 / $169.82	Professional		$22.39	$52.48	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $19.95 / $60.26	Professional	26	$8.91	$19.95	$60.26
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $44.67 / $109.65 / $269.15	Professional	50	$44.67	$109.65	$269.15
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $43.65 / $43.65 / $43.65	Professional	52	$43.65	$43.65	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $38.90 / $89.13	Professional	TC	$22.91	$38.90	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $39.81 / $75.86	Professional		$30.90	$39.81	$75.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.48 / $19.05	Professional	26	$8.32	$11.48	$19.05
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $50.12 / $61.66 / $117.49	Professional	50	$50.12	$61.66	$117.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $41.69 / $61.66	Professional	TC	$25.12	$41.69	$61.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.69 / $12.59 / $21.38	Facility	26	$2.69	$12.59	$21.38
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $8.51 / $39.81 / $56.23	Facility	TC	$8.51	$39.81	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $41.69 / $87.10	Professional		$29.51	$41.69	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.02 / $25.12	Professional	26	$7.76	$12.02	$25.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $30.90 / $70.79	Professional	TC	$21.38	$30.90	$70.79
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $11.75 / $11.75	Facility	26	$11.75	$11.75	$11.75
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 $30.20 / $37.15 / $60.26	Professional		$30.20	$37.15	$60.26
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.47 / $15.85	Professional	26	$7.76	$10.47	$15.85
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $27.54 / $44.67	Professional	TC	$21.38	$27.54	$44.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.61 / $29.51 / $47.86	Professional		$6.61	$29.51	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $38.02 / $67.61	Professional		$30.20	$38.02	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.23 / $19.05	Professional	26	$8.51	$10.23	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $27.54 / $48.98	Professional	TC	$21.88	$27.54	$48.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $25.70 / $47.86	Professional		$25.70	$25.70	$47.86
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $6.03 / $10.96	Professional	26	$6.03	$6.03	$10.96
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $19.95 / $37.15	Professional	TC	$19.95	$19.95	$37.15