Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $234.42 / $575.44	Facility		$45.71	$234.42	$575.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.01 / $5.75 / $22.91	Facility	26	$5.01	$5.75	$22.91
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $13.18 / $83.18 / $257.04	Facility	TC	$13.18	$83.18	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $33.88 / $97.72	Professional		$16.60	$33.88	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $13.18 / $38.90	Professional	26	$5.89	$13.18	$38.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $22.39 / $75.86 / $190.55	Professional	50	$22.39	$75.86	$190.55
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.22 / $28.18 / $112.20	Professional	52	$16.22	$28.18	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $20.89 / $48.98	Professional	TC	$14.13	$20.89	$48.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $22.39 / $41.69	Professional		$18.20	$22.39	$41.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $7.59 / $13.49	Professional	26	$5.75	$7.59	$13.49
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $28.18 / $33.11 / $66.07	Professional	50	$28.18	$33.11	$66.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $16.22 / $25.12	Professional	TC	$13.49	$16.22	$25.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $104.71 / $177.83	Facility		$45.71	$104.71	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.82 / $8.51 / $14.45	Facility	26	$1.82	$8.51	$14.45
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $4.90 / $22.91 / $32.36	Facility	TC	$4.90	$22.91	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $26.92 / $54.95	Professional		$19.05	$26.92	$54.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.25 / $8.32 / $16.60	Professional	26	$5.25	$8.32	$16.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $20.42 / $43.65	Professional	TC	$13.80	$20.42	$43.65
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $56.23 / $107.15	Facility		$18.62	$56.23	$107.15
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $8.13 / $8.13	Facility	26	$8.13	$8.13	$8.13
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $19.05 / $19.05 / $19.05	Facility	TC	$19.05	$19.05	$19.05
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $25.12 / $38.02	Professional		$19.50	$25.12	$38.02
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $5.37 / $7.41 / $10.96	Professional	26	$5.37	$7.41	$10.96
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $16.98 / $27.54	Professional	TC	$14.13	$16.98	$27.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.13 / $19.50 / $33.11	Professional		$5.13	$19.50	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $10.96 / $64.57 / $144.54	Facility		$10.96	$64.57	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $24.55 / $43.65	Professional		$20.42	$24.55	$43.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $6.92 / $12.88	Professional	26	$5.89	$6.92	$12.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $17.38 / $30.90	Professional	TC	$14.13	$17.38	$30.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $16.98 / $28.18	Professional		$16.98	$16.98	$28.18
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.37 / $4.37 / $7.76	Professional	26	$4.37	$4.37	$7.76
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $12.59 / $20.42	Professional	TC	$12.59	$12.59	$20.42