Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.73 / $23.14 / $89.48	Facility	26	$18.73	$23.14	$89.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.12 / $60.16 / $142.32	Professional		$43.12	$60.16	$142.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.73 / $24.98 / $76.38	Professional	26	$18.73	$24.98	$76.38
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $21.56 / $26.72 / $46.46	Professional	52	$21.56	$26.72	$46.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.39 / $31.93 / $86.42	Professional	TC	$24.39	$31.93	$86.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.89 / $45.77 / $95.92	Professional		$34.89	$45.77	$95.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.46 / $27.07 / $59.26	Professional	26	$12.46	$27.07	$59.26
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $8.76 / $12.58 / $57.96	Professional	52	$8.76	$12.58	$57.96
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.22 / $22.22 / $22.74	Professional	TC	$22.22	$22.22	$22.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.97 / $30.97 / $78.56	Facility	26	$30.97	$30.97	$78.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.35 / $79.48 / $156.19	Professional		$39.35	$79.48	$156.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.61 / $28.01 / $55.31	Professional	26	$19.61	$28.01	$55.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.73 / $51.44 / $102.64	Professional	TC	$19.73	$51.44	$102.64
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $28.59 / $28.59 / $28.59	Facility	26	$28.59	$28.59	$28.59
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $38.31 / $81.03 / $115.77	Professional		$38.31	$81.03	$115.77
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $18.39 / $28.59 / $37.53	Professional	26	$18.39	$28.59	$37.53
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $21.96 / $52.96 / $80.02	Professional	TC	$21.96	$52.96	$80.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.40 / $48.51 / $90.47	Professional		$28.40	$48.51	$90.47
United Facility/Professional Professional Modifier Low / Median / High Price $60.38 / $70.23 / $129.38	Professional		$60.38	$70.23	$129.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.96 / $23.94 / $42.27	Professional	26	$20.96	$23.94	$42.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.64 / $47.94 / $86.94	Professional	TC	$38.64	$47.94	$86.94
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $43.23 / $43.23 / $43.23	Professional		$43.23	$43.23	$43.23
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $20.22 / $20.22 / $20.22	Professional	26	$20.22	$20.22	$20.22
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $23.00 / $23.00 / $23.00	Professional	TC	$23.00	$23.00	$23.00