Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.20 / $441.57 / $1,181.70	Facility		$99.20	$441.57	$1,181.70
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.16 / $31.56 / $90.51	Facility	26	$19.16	$31.56	$90.51
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $51.33 / $276.39 / $633.87	Facility	TC	$51.33	$276.39	$633.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.24 / $89.31 / $257.61	Professional		$58.24	$89.31	$257.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.16 / $28.97 / $113.00	Professional	26	$19.16	$28.97	$113.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.09 / $57.07 / $115.68	Professional	TC	$39.09	$57.07	$115.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.09 / $67.98 / $132.57	Professional		$54.09	$67.98	$132.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.49 / $27.67 / $58.71	Professional	26	$20.49	$27.67	$58.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.95 / $45.91 / $70.97	Professional	TC	$40.95	$45.91	$70.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.48 / $202.30 / $327.61	Facility		$68.48	$202.30	$327.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.67 / $31.67 / $85.58	Facility	26	$31.67	$31.67	$85.58
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $66.73 / $66.73 / $175.11	Facility	TC	$66.73	$66.73	$175.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.53 / $95.13 / $186.71	Professional		$60.53	$95.13	$186.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.05 / $30.14 / $59.12	Professional	26	$20.05	$30.14	$59.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.47 / $64.53 / $128.09	Professional	TC	$40.47	$64.53	$128.09
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $87.78 / $191.24 / $306.52	Facility		$87.78	$191.24	$306.52
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $31.13 / $31.13 / $31.13	Facility	26	$31.13	$31.13	$31.13
Florida Blue Facility/Professional Facility Modifier TC Low / Median / High Price $64.75 / $64.75 / $64.75	Facility	TC	$64.75	$64.75	$64.75
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $56.62 / $89.89 / $125.60	Professional		$56.62	$89.89	$125.60
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $18.82 / $30.74 / $40.86	Professional	26	$18.82	$30.74	$40.86
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $37.79 / $59.39 / $85.53	Professional	TC	$37.79	$59.39	$85.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.06 / $82.37 / $141.22	Professional		$36.06	$82.37	$141.22
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 $69.84 / $82.20 / $143.55	Professional		$69.84	$82.20	$143.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.48 / $24.87 / $53.02	Professional	26	$22.48	$24.87	$53.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.60 / $57.30 / $102.29	Professional	TC	$47.60	$57.30	$102.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.73 / $54.73 / $54.73	Professional		$54.73	$54.73	$54.73
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $17.19 / $17.19 / $17.19	Professional	26	$17.19	$17.19	$17.19
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $37.53 / $37.53 / $37.53	Professional	TC	$37.53	$37.53	$37.53