Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.68 / $237.66 / $582.41	Facility		$45.68	$237.66	$582.41
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.45 / $7.06 / $27.11	Facility	26	$5.45	$7.06	$27.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $15.23 / $69.84 / $302.48	Facility	TC	$15.23	$69.84	$302.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.68 / $28.46 / $61.10	Professional		$20.68	$28.46	$61.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.45 / $7.64 / $25.24	Professional	26	$5.45	$7.64	$25.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $60.75 / $60.75 / $60.75	Professional	50	$60.75	$60.75	$60.75
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.34 / $13.32 / $19.59	Professional	52	$10.34	$13.32	$19.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.23 / $21.00 / $40.03	Professional	TC	$15.23	$21.00	$40.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.10 / $23.87 / $37.29	Professional		$19.10	$23.87	$37.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.67 / $8.64 / $17.05	Professional	26	$5.67	$8.64	$17.05
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $30.44 / $30.44 / $46.34	Professional	50	$30.44	$30.44	$46.34
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.21 / $18.79 / $18.79	Professional	TC	$15.21	$18.79	$18.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.17 / $99.23 / $163.37	Facility		$25.17	$99.23	$163.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $24.47	Facility	26	$8.86	$8.86	$24.47
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.59 / $27.59 / $59.64	Facility	TC	$27.59	$27.59	$59.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.69 / $30.92 / $59.04	Professional		$20.69	$30.92	$59.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.70 / $9.11 / $16.39	Professional	26	$5.70	$9.11	$16.39
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.11 / $40.11 / $40.11	Professional	50	$40.11	$40.11	$40.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.65 / $22.51 / $44.77	Professional	TC	$15.65	$22.51	$44.77
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $29.63 / $66.34 / $106.33	Facility		$29.63	$66.34	$106.33
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $8.94 / $8.94 / $8.94	Facility	26	$8.94	$8.94	$8.94
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $22.25 / $22.25 / $22.25	Facility	TC	$22.25	$22.25	$22.25
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $21.04 / $31.19 / $40.94	Professional		$21.04	$31.19	$40.94
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $5.58 / $9.27 / $11.74	Professional	26	$5.58	$9.27	$11.74
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $15.66 / $21.78 / $30.91	Professional	TC	$15.66	$21.78	$30.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.80 / $33.40 / $55.11	Professional		$14.80	$33.40	$55.11
United Facility/Professional Facility Modifier Low / Median / High Price $45.95 / $145.62 / $404.03	Facility		$45.95	$145.62	$404.03
United Facility/Professional Professional Modifier Low / Median / High Price $21.15 / $26.30 / $54.60	Professional		$21.15	$26.30	$54.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.15 / $7.37 / $15.20	Professional	26	$6.15	$7.37	$15.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.73 / $19.11 / $38.86	Professional	TC	$14.73	$19.11	$38.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $17.69 / $17.69 / $17.69	Professional		$17.69	$17.69	$17.69
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.19 / $4.19 / $4.19	Professional	26	$4.19	$4.19	$4.19
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $13.49 / $13.49	Professional	TC	$13.49	$13.49	$13.49