Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.38 / $25.34 / $75.02	Facility	26	$15.38	$25.34	$75.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.18 / $45.90 / $169.20	Professional		$30.18	$45.90	$169.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.38 / $25.22 / $84.60	Professional	26	$15.38	$25.22	$84.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $126.90 / $126.90 / $126.90	Professional	50	$126.90	$126.90	$126.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.18 / $21.69 / $51.13	Professional	TC	$9.18	$21.69	$51.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.21 / $50.88 / $99.77	Professional		$39.21	$50.88	$99.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.21 / $32.61 / $59.11	Professional	26	$24.21	$32.61	$59.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $24.73 / $32.11	Professional	TC	$23.23	$24.73	$32.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.43 / $37.43 / $71.50	Facility	26	$37.43	$37.43	$71.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.30 / $43.58 / $102.44	Professional		$27.30	$43.58	$102.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $26.32 / $55.15	Professional	26	$17.39	$26.32	$55.15
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.87 / $74.87 / $127.11	Professional	50	$74.87	$74.87	$127.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $6.36 / $15.04 / $54.52	Professional	TC	$6.36	$15.04	$54.52
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $26.07 / $26.07 / $26.07	Facility	26	$26.07	$26.07	$26.07
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $25.89 / $39.49 / $57.83	Professional		$25.89	$39.49	$57.83
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $17.11 / $23.46 / $37.47	Professional	26	$17.11	$23.46	$37.47
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $8.69 / $13.04 / $23.19	Professional	TC	$8.69	$13.04	$23.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.97 / $45.89 / $89.22	Professional		$25.97	$45.89	$89.22
United Facility/Professional Professional Modifier Low / Median / High Price $26.21 / $45.13 / $81.16	Professional		$26.21	$45.13	$81.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $20.43 / $42.76	Professional	26	$17.39	$20.43	$42.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.60 / $23.68 / $41.22	Professional	TC	$8.60	$23.68	$41.22
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.46 / $21.46 / $21.46	Professional		$21.46	$21.46	$21.46
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $10.96 / $10.96	Professional	26	$10.96	$10.96	$10.96
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $10.50 / $10.50 / $10.50	Professional	TC	$10.50	$10.50	$10.50