Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.98 / $271.80 / $645.03	Facility		$60.98	$271.80	$645.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.45 / $16.25 / $378.93	Facility	26	$5.45	$16.25	$378.93
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.55 / $321.38 / $622.70	Facility	TC	$23.55	$321.38	$622.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.76 / $34.84 / $119.94	Professional		$21.76	$34.84	$119.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.46 / $8.33 / $43.12	Professional	26	$5.46	$8.33	$43.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.60 / $53.60 / $123.21	Professional	50	$15.60	$53.60	$123.21
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.88 / $14.12 / $20.62	Professional	52	$10.88	$14.12	$20.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.30 / $24.17 / $62.00	Professional	TC	$16.30	$24.17	$62.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.81 / $27.39 / $47.52	Professional		$20.81	$27.39	$47.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.96 / $8.28 / $16.51	Professional	26	$5.96	$8.28	$16.51
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $33.26 / $38.02 / $49.25	Professional	50	$33.26	$38.02	$49.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $20.30 / $29.95	Professional	TC	$18.62	$20.30	$29.95
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 $9.25 / $9.25 / $24.50	Facility	26	$9.25	$9.25	$24.50
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.46 / $29.46 / $58.66	Facility	TC	$29.46	$29.46	$58.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.45 / $32.26 / $62.00	Professional		$22.45	$32.26	$62.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.71 / $9.44 / $17.26	Professional	26	$5.71	$9.44	$17.26
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.56 / $40.56 / $40.56	Professional	50	$40.56	$40.56	$40.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.94 / $24.12 / $47.72	Professional	TC	$16.94	$24.12	$47.72
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $28.93 / $71.45 / $114.54	Facility		$28.93	$71.45	$114.54
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $8.93 / $8.93 / $8.93	Facility	26	$8.93	$8.93	$8.93
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $21.52 / $21.52 / $21.52	Facility	TC	$21.52	$21.52	$21.52
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $22.18 / $31.59 / $43.36	Professional		$22.18	$31.59	$43.36
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $5.81 / $9.36 / $11.72	Professional	26	$5.81	$9.36	$11.72
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $16.41 / $21.58 / $31.20	Professional	TC	$16.41	$21.58	$31.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.51 / $33.44 / $55.11	Professional		$14.51	$33.44	$55.11
United Facility/Professional Facility Modifier Low / Median / High Price $45.95 / $145.62 / $179.57	Facility		$45.95	$145.62	$179.57
United Facility/Professional Professional Modifier Low / Median / High Price $22.71 / $27.53 / $56.44	Professional		$22.71	$27.53	$56.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $7.41 / $15.29	Professional	26	$6.46	$7.41	$15.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.14 / $19.98 / $41.72	Professional	TC	$16.14	$19.98	$41.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $17.25 / $17.25 / $17.25	Professional		$17.25	$17.25	$17.25
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.01 / $4.01 / $4.01	Professional	26	$4.01	$4.01	$4.01
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $13.23 / $13.23 / $13.23	Professional	TC	$13.23	$13.23	$13.23