Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $234.42 / $562.34	Facility		$40.74	$234.42	$562.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $26.30 / $489.78	Facility	26	$19.05	$26.30	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $83.18 / $199.53	Professional		$33.11	$83.18	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $38.02 / $154.88	Professional	26	$19.95	$38.02	$154.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.13 / $177.83 / $363.08	Professional	50	$74.13	$177.83	$363.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $18.20 / $58.88	Professional	TC	$11.48	$18.20	$58.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $39.81 / $83.18	Professional		$33.88	$39.81	$83.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $51.29 / $95.50	Professional	26	$39.81	$51.29	$95.50
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $48.98 / $57.54 / $151.36	Professional	50	$48.98	$57.54	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $245.47 / $346.74	Facility		$112.20	$245.47	$346.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.24 / $33.88 / $58.88	Facility	26	$7.24	$33.88	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $74.13 / $151.36	Professional		$34.67	$74.13	$151.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $43.65 / $87.10	Professional	26	$21.38	$43.65	$87.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $33.11 / $77.62	Professional	TC	$12.30	$33.11	$77.62
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $177.83 / $331.13	Facility		$70.79	$177.83	$331.13
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $54.95 / $54.95	Facility	26	$54.95	$54.95	$54.95
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $77.62 / $120.23	Professional		$34.67	$77.62	$120.23
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $41.69 / $67.61	Professional	26	$21.38	$41.69	$67.61
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $33.11 / $61.66	Professional	TC	$13.18	$33.11	$61.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $32.36 / $46.77	Professional		$14.79	$32.36	$46.77
United Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $91.20 / $239.88	Facility		$30.90	$91.20	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $72.44 / $123.03	Professional		$41.69	$72.44	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $38.90 / $64.57	Professional	26	$25.12	$38.90	$64.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $30.20 / $60.26	Professional	TC	$16.60	$30.20	$60.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $47.86	Professional		$36.31	$36.31	$47.86
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $22.91 / $29.51	Professional	26	$22.91	$22.91	$29.51
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $13.49 / $17.78	Professional	TC	$13.49	$13.49	$17.78