Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.83 / $4,114.35 / $5,808.00	Facility		$103.83	$4,114.35	$5,808.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.86 / $68.62 / $292.74	Facility	26	$56.86	$68.62	$292.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.83 / $153.15 / $276.63	Professional		$103.83	$153.15	$276.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $65.95 / $121.17	Professional	26	$48.86	$65.95	$121.17
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $51.92 / $67.42 / $123.62	Professional	52	$51.92	$67.42	$123.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.97 / $72.08 / $200.40	Professional	TC	$46.97	$72.08	$200.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.38 / $113.99 / $113.99	Professional		$105.38	$113.99	$113.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $58.82 / $72.36 / $180.69	Professional	26	$58.82	$72.36	$180.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.79 / $4,340.70 / $6,639.76	Facility		$208.79	$4,340.70	$6,639.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.06 / $94.06 / $254.79	Facility	26	$94.06	$94.06	$254.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.74 / $205.51 / $585.16	Professional		$105.74	$205.51	$585.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.76 / $71.43 / $155.18	Professional	26	$47.76	$71.43	$155.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.40 / $111.86 / $503.21	Professional	TC	$46.40	$111.86	$503.21
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $492.35 / $1,691.52 / $2,711.20	Facility		$492.35	$1,691.52	$2,711.20
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $61.20 / $61.20 / $61.20	Facility	26	$61.20	$61.20	$61.20
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $106.87 / $202.97 / $531.97	Professional		$106.87	$202.97	$531.97
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $47.22 / $64.89 / $96.40	Professional	26	$47.22	$64.89	$96.40
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $49.28 / $130.29 / $473.23	Professional	TC	$49.28	$130.29	$473.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.82 / $97.05 / $173.05	Professional		$54.82	$97.05	$173.05
United Facility/Professional Professional Modifier Low / Median / High Price $130.13 / $190.32 / $433.16	Professional		$130.13	$190.32	$433.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.53 / $72.51 / $143.41	Professional	26	$44.53	$72.51	$143.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.67 / $95.33 / $317.51	Professional	TC	$59.67	$95.33	$317.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $96.40 / $96.40 / $96.40	Professional		$96.40	$96.40	$96.40
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $52.06 / $52.06 / $52.06	Professional	26	$52.06	$52.06	$52.06
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $44.35 / $44.35 / $44.35	Professional	TC	$44.35	$44.35	$44.35