Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $295.12 / $1,096.48	Facility		$46.77	$295.12	$1,096.48
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $10.00 / $46.77	Facility	26	$8.91	$10.00	$46.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $37.15 / $89.13	Professional		$24.55	$37.15	$89.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $18.20 / $60.26	Professional	26	$9.55	$18.20	$60.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $21.88 / $48.98	Professional	TC	$15.49	$21.88	$48.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $30.90 / $39.81	Professional		$27.54	$30.90	$39.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $14.79 / $25.12	Professional	26	$10.23	$14.79	$25.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $43.65 / $58.88	Facility		$32.36	$43.65	$58.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.31 / $15.49 / $26.30	Facility	26	$3.31	$15.49	$26.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $36.31 / $72.44	Professional		$25.12	$36.31	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $15.85 / $31.62	Professional	26	$10.23	$15.85	$31.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $20.89 / $46.77	Professional	TC	$14.79	$20.89	$46.77
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $20.89 / $33.11	Facility		$19.95	$20.89	$33.11
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $15.49 / $15.49	Facility	26	$15.49	$15.49	$15.49
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $30.90 / $47.86	Professional		$23.44	$30.90	$47.86
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.49 / $20.42	Professional	26	$9.77	$13.49	$20.42
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $18.20 / $30.20	Professional	TC	$12.30	$18.20	$30.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $22.39 / $33.11	Professional		$7.94	$22.39	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $11.75 / $20.42 / $34.67	Facility		$11.75	$20.42	$34.67
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $31.62 / $54.95	Professional		$25.70	$31.62	$54.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $13.18 / $23.44	Professional	26	$11.22	$13.18	$23.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $18.62 / $32.36	Professional	TC	$14.13	$18.62	$32.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $39.81	Professional		$20.42	$20.42	$39.81
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $7.08 / $13.80	Professional	26	$7.08	$7.08	$13.80
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $13.49 / $25.70	Professional	TC	$13.49	$13.49	$25.70