Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.23 / $14.23 / $37.21	Facility	26	$7.23	$14.23	$37.21
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $29.98 / $332.77 / $698.01	Facility	TC	$29.98	$332.77	$698.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.07 / $45.14 / $144.40	Professional		$29.07	$45.14	$144.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $11.50 / $58.14	Professional	26	$7.23	$11.50	$58.14
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $70.64 / $87.75 / $296.00	Professional	50	$70.64	$87.75	$296.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.54 / $18.91 / $27.62	Professional	52	$14.54	$18.91	$27.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.84 / $31.57 / $65.18	Professional	TC	$21.84	$31.57	$65.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.01 / $37.35 / $72.02	Professional		$28.01	$37.35	$72.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.86 / $11.16 / $21.89	Professional	26	$7.86	$11.16	$21.89
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $52.55 / $52.73 / $86.48	Professional	50	$52.55	$52.73	$86.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.65 / $30.93 / $65.56	Professional	TC	$26.65	$30.93	$65.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.66 / $12.66 / $32.54	Facility	26	$12.66	$12.66	$32.54
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $40.63 / $40.63 / $79.36	Facility	TC	$40.63	$40.63	$79.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.36 / $42.96 / $82.16	Professional		$30.36	$42.96	$82.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $12.74 / $22.53	Professional	26	$7.79	$12.74	$22.53
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $53.72 / $53.72 / $53.72	Professional	50	$53.72	$53.72	$53.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.92 / $32.08 / $64.36	Professional	TC	$22.92	$32.08	$64.36
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $11.82 / $11.82 / $11.82	Facility	26	$11.82	$11.82	$11.82
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $29.58 / $29.58 / $29.58	Facility	TC	$29.58	$29.58	$29.58
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $30.76 / $41.51 / $59.51	Professional		$30.76	$41.51	$59.51
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $7.87 / $12.71 / $15.52	Professional	26	$7.87	$12.71	$15.52
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $22.19 / $28.84 / $42.90	Professional	TC	$22.19	$28.84	$42.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.63 / $33.59 / $56.73	Professional		$18.63	$33.59	$56.73
United Facility/Professional Professional Modifier Low / Median / High Price $30.04 / $36.18 / $78.30	Professional		$30.04	$36.18	$78.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $10.00 / $20.28	Professional	26	$8.36	$10.00	$20.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.62 / $26.66 / $52.54	Professional	TC	$21.62	$26.66	$52.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.57 / $23.57 / $23.57	Professional		$23.57	$23.57	$23.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.48 / $5.48 / $5.48	Professional	26	$5.48	$5.48	$5.48
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $18.09 / $18.09 / $18.09	Professional	TC	$18.09	$18.09	$18.09