Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.43 / $278.52 / $683.25	Facility		$44.43	$278.52	$683.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.66 / $11.75 / $260.19	Facility	26	$5.66	$11.75	$260.19
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.22 / $199.98 / $527.72	Facility	TC	$20.22	$199.98	$527.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.99 / $34.20 / $91.80	Professional		$22.99	$34.20	$91.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.67 / $8.63 / $43.70	Professional	26	$5.67	$8.63	$43.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.78 / $66.15 / $126.54	Professional	50	$39.78	$66.15	$126.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.63 / $15.05 / $22.08	Professional	52	$11.63	$15.05	$22.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $25.72 / $62.26	Professional	TC	$17.57	$25.72	$62.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.99 / $28.56 / $50.72	Professional		$22.99	$28.56	$50.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.14 / $8.46 / $17.16	Professional	26	$6.14	$8.46	$17.16
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $31.09 / $37.94 / $52.58	Professional	50	$31.09	$37.94	$52.58
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.54 / $20.57 / $35.82	Professional	TC	$20.54	$20.57	$35.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.89 / $99.23 / $163.37	Facility		$26.89	$99.23	$163.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $25.48	Facility	26	$9.61	$9.61	$25.48
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $31.68 / $31.68 / $63.58	Facility	TC	$31.68	$31.68	$63.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.84 / $33.90 / $65.54	Professional		$23.84	$33.90	$65.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.94 / $9.67 / $17.26	Professional	26	$5.94	$9.67	$17.26
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.28 / $43.28 / $43.28	Professional	50	$43.28	$43.28	$43.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.93 / $25.82 / $51.43	Professional	TC	$17.93	$25.82	$51.43
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $31.36 / $71.45 / $114.54	Facility		$31.36	$71.45	$114.54
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $23.71 / $23.71 / $23.71	Facility	TC	$23.71	$23.71	$23.71
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $23.67 / $33.18 / $46.27	Professional		$23.67	$33.18	$46.27
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $6.04 / $9.72 / $12.20	Professional	26	$6.04	$9.72	$12.20
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $23.43 / $34.38	Professional	TC	$17.78	$23.43	$34.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.87 / $33.44 / $55.74	Professional		$15.87	$33.44	$55.74
United Facility/Professional Facility Modifier Low / Median / High Price $8.96 / $23.60 / $179.57	Facility		$8.96	$23.60	$179.57
United Facility/Professional Professional Modifier Low / Median / High Price $23.74 / $29.50 / $61.40	Professional		$23.74	$29.50	$61.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.57 / $7.60 / $15.83	Professional	26	$6.57	$7.60	$15.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $21.44 / $44.14	Professional	TC	$17.14	$21.44	$44.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $18.72 / $18.72 / $18.72	Professional		$18.72	$18.72	$18.72
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.26 / $4.26 / $4.26	Professional	26	$4.26	$4.26	$4.26
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.47 / $14.47 / $14.47	Professional	TC	$14.47	$14.47	$14.47