Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $234.42 / $537.03	Facility		$50.12	$234.42	$537.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.89 / $6.31 / $17.38	Facility	26	$5.89	$6.31	$17.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $13.18 / $72.44 / $338.84	Facility	TC	$13.18	$72.44	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $38.90 / $109.65	Professional		$19.95	$38.90	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.00 / $41.69	Professional	26	$7.08	$10.00	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $21.88 / $48.98	Professional	TC	$14.13	$21.88	$48.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $22.91 / $48.98	Professional		$18.62	$22.91	$48.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $8.91 / $14.45	Professional	26	$6.61	$8.91	$14.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $17.78 / $27.54	Professional	TC	$13.18	$17.78	$27.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $173.78 / $234.42	Facility		$45.71	$173.78	$234.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.14 / $10.00 / $16.98	Facility	26	$2.14	$10.00	$16.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.01 / $23.44 / $33.11	Facility	TC	$5.01	$23.44	$33.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $28.84 / $57.54	Professional		$20.42	$28.84	$57.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $10.00 / $19.50	Professional	26	$6.17	$10.00	$19.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $19.95 / $41.69	Professional	TC	$13.80	$19.95	$41.69
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $67.61 / $112.20	Facility		$28.18	$67.61	$112.20
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $9.55 / $9.55	Facility	26	$9.55	$9.55	$9.55
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 $20.42 / $25.12 / $39.81	Professional		$20.42	$25.12	$39.81
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $8.32 / $12.59	Professional	26	$6.17	$8.32	$12.59
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $16.60 / $26.92	Professional	TC	$14.13	$16.60	$26.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.03 / $21.88 / $33.11	Professional		$6.03	$21.88	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $11.48 / $64.57 / $144.54	Facility		$11.48	$64.57	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $25.12 / $46.77	Professional		$20.89	$25.12	$46.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $8.32 / $15.49	Professional	26	$7.08	$8.32	$15.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $17.38 / $30.90	Professional	TC	$13.80	$17.38	$30.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $18.20 / $28.84	Professional		$18.20	$18.20	$28.84
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.25 / $5.25 / $8.71	Professional	26	$5.25	$5.25	$8.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $12.88 / $20.42	Professional	TC	$12.88	$12.88	$20.42