Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.45 / $53.25 / $427.43	Facility		$31.45	$53.25	$427.43
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.84 / $25.19 / $102.20	Facility	26	$19.84	$25.19	$102.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.45 / $50.01 / $124.20	Professional		$31.45	$50.01	$124.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.84 / $28.99 / $63.45	Professional	26	$19.84	$28.99	$63.45
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $82.23 / $179.00 / $359.10	Professional	50	$82.23	$179.00	$359.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.61 / $16.42 / $48.34	Professional	TC	$11.61	$16.42	$48.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.14 / $46.91 / $85.86	Professional	26	$40.14	$46.91	$85.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.06 / $232.84 / $334.04	Facility		$75.06	$232.84	$334.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.29 / $34.29 / $122.16	Facility	26	$34.29	$34.29	$122.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.93 / $72.34 / $149.41	Professional		$32.93	$72.34	$149.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.99 / $41.34 / $83.00	Professional	26	$20.99	$41.34	$83.00
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.23 / $79.23 / $79.23	Professional	50	$79.23	$79.23	$79.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.94 / $31.88 / $75.04	Professional	TC	$11.94	$31.88	$75.04
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $91.03 / $206.03 / $330.24	Facility		$91.03	$206.03	$330.24
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $54.52 / $54.52 / $54.52	Facility	26	$54.52	$54.52	$54.52
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $33.68 / $89.84 / $120.98	Professional		$33.68	$89.84	$120.98
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $21.32 / $42.63 / $68.15	Professional	26	$21.32	$42.63	$68.15
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $12.66 / $40.26 / $63.13	Professional	TC	$12.66	$40.26	$63.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.43 / $46.91 / $89.22	Professional		$27.43	$46.91	$89.22
United Facility/Professional Facility Modifier Low / Median / High Price $99.32 / $252.18 / $567.40	Facility		$99.32	$252.18	$567.40
United Facility/Professional Professional Modifier Low / Median / High Price $41.83 / $71.81 / $121.00	Professional		$41.83	$71.81	$121.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.31 / $38.42 / $64.33	Professional	26	$25.31	$38.42	$64.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.52 / $30.25 / $62.48	Professional	TC	$16.52	$30.25	$62.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.90 / $36.90 / $36.90	Professional		$36.90	$36.90	$36.90
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.07 / $23.07 / $23.07	Professional	26	$23.07	$23.07	$23.07
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $13.84 / $13.84 / $13.84	Professional	TC	$13.84	$13.84	$13.84