Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.40 / $25.27 / $111.95	Facility	26	$23.40	$25.27	$111.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.02 / $95.71 / $188.41	Professional		$68.02	$95.71	$188.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.40 / $32.51 / $69.03	Professional	26	$23.40	$32.51	$69.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $119.25 / $633.00 / $749.61	Professional	50	$119.25	$633.00	$749.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.62 / $62.21 / $109.98	Professional	TC	$44.62	$62.21	$109.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $80.06 / $111.67	Professional		$61.00	$80.06	$111.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.71 / $40.46 / $75.87	Professional	26	$25.71	$40.46	$75.87
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $92.28 / $120.09 / $193.00	Professional	50	$92.28	$120.09	$193.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $74.09 / $75.39 / $75.39	Professional	TC	$74.09	$75.39	$75.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.72 / $39.72 / $106.06	Facility	26	$39.72	$39.72	$106.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.98 / $112.76 / $220.75	Professional		$70.98	$112.76	$220.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.71 / $39.04 / $76.05	Professional	26	$24.71	$39.04	$76.05
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $138.68 / $138.68 / $138.68	Professional	50	$138.68	$138.68	$138.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.28 / $73.44 / $146.41	Professional	TC	$46.28	$73.44	$146.41
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $38.61 / $38.61 / $38.61	Facility	26	$38.61	$38.61	$38.61
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $66.72 / $107.37 / $147.69	Professional		$66.72	$107.37	$147.69
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $23.60 / $37.90 / $50.67	Professional	26	$23.60	$37.90	$50.67
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $43.11 / $69.45 / $97.01	Professional	TC	$43.11	$69.45	$97.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $82.73 / $142.84	Professional		$37.20	$82.73	$142.84
United Facility/Professional Professional Modifier Low / Median / High Price $81.97 / $90.46 / $168.31	Professional		$81.97	$90.46	$168.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.41 / $32.22 / $59.47	Professional	26	$28.41	$32.22	$59.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.12 / $59.10 / $107.73	Professional	TC	$53.12	$59.10	$107.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $63.07 / $63.07 / $63.07	Professional		$63.07	$63.07	$63.07
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $21.09 / $21.09 / $21.09	Professional	26	$21.09	$21.09	$21.09
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $41.98 / $41.98 / $41.98	Professional	TC	$41.98	$41.98	$41.98