Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $288.40 / $812.83	Facility		$44.67	$288.40	$812.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.25 / $8.71 / $74.13	Facility	26	$5.25	$8.71	$74.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $14.79 / $134.90 / $426.58	Facility	TC	$14.79	$134.90	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $32.36 / $95.50	Professional		$10.00	$32.36	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $11.48 / $40.74	Professional	26	$6.03	$11.48	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.98 / $72.44 / $162.18	Professional	50	$16.98	$72.44	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $25.12 / $57.54	Professional	TC	$15.14	$25.12	$57.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $25.12 / $47.86	Professional		$19.50	$25.12	$47.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $7.94 / $13.49	Professional	26	$5.75	$7.94	$13.49
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $30.90 / $56.23 / $79.43	Professional	50	$30.90	$56.23	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $21.88 / $37.15	Professional	TC	$15.14	$21.88	$37.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $104.71 / $177.83	Facility		$41.69	$104.71	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $15.14	Facility	26	$1.86	$8.71	$15.14
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.62 / $26.30 / $37.15	Facility	TC	$5.62	$26.30	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $28.84 / $60.26	Professional		$19.95	$28.84	$60.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.50 / $9.12 / $17.78	Professional	26	$5.50	$9.12	$17.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $20.89 / $46.77	Professional	TC	$14.45	$20.89	$46.77
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $60.26 / $112.20	Facility		$19.95	$60.26	$112.20
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $8.91 / $8.91	Facility	26	$8.91	$8.91	$8.91
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $21.38 / $21.38 / $21.38	Facility	TC	$21.38	$21.38	$21.38
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $27.54 / $41.69	Professional		$21.38	$27.54	$41.69
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $5.37 / $7.94 / $11.48	Professional	26	$5.37	$7.94	$11.48
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $18.62 / $30.90	Professional	TC	$15.14	$18.62	$30.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.25 / $21.38 / $34.67	Professional		$5.25	$21.38	$34.67
United Facility/Professional Facility Modifier Low / Median / High Price $12.02 / $64.57 / $144.54	Facility		$12.02	$64.57	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $26.30 / $47.86	Professional		$21.38	$26.30	$47.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $7.41 / $13.80	Professional	26	$6.31	$7.41	$13.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $18.62 / $34.67	Professional	TC	$14.45	$18.62	$34.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $18.62 / $30.90	Professional		$18.62	$18.62	$30.90
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.57 / $4.57 / $7.76	Professional	26	$4.57	$4.57	$7.76
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $14.13 / $22.91	Professional	TC	$14.13	$14.13	$22.91