Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.50 / $22.39 / $72.44	Facility	26	$19.50	$22.39	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $61.66 / $173.78	Professional		$37.15	$61.66	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $43.65 / $97.72	Professional	26	$22.39	$43.65	$97.72
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.99 / $47.86 / $177.83	Professional	52	$23.99	$47.86	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $25.70 / $61.66	Professional	TC	$15.85	$25.70	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $41.69 / $75.86	Professional		$33.88	$41.69	$75.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $29.51 / $46.77	Professional	26	$21.38	$29.51	$46.77
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $9.77 / $12.59 / $34.67	Professional	52	$9.77	$12.59	$34.67
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $19.50 / $38.02	Professional	TC	$14.79	$19.50	$38.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $32.36 / $56.23	Facility	26	$6.92	$32.36	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $56.23 / $109.65	Professional		$36.31	$56.23	$109.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $31.62 / $63.10	Professional	26	$20.42	$31.62	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $26.30 / $53.70	Professional	TC	$16.22	$26.30	$53.70
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $37.15 / $37.15	Facility	26	$37.15	$37.15	$37.15
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $56.23 / $85.11	Professional		$35.48	$56.23	$85.11
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $30.90 / $46.77	Professional	26	$19.50	$30.90	$46.77
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $25.70 / $38.02	Professional	TC	$15.49	$25.70	$38.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $33.11 / $60.26	Professional		$18.20	$33.11	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $52.48 / $89.13	Professional		$41.69	$52.48	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $28.18 / $48.98	Professional	26	$22.91	$28.18	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $23.44 / $40.74	Professional	TC	$18.62	$23.44	$40.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $50.12	Professional		$36.31	$36.31	$50.12
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.50 / $27.54	Professional	26	$19.50	$19.50	$27.54
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $16.60 / $22.39	Professional	TC	$16.60	$16.60	$22.39