Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $21.16 / $92.65	Facility	26	$19.60	$21.16	$92.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.14 / $52.20 / $108.00	Professional		$35.14	$52.20	$108.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.60 / $28.00 / $73.34	Professional	26	$19.60	$28.00	$73.34
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $36.68 / $62.31 / $220.80	Professional	52	$36.68	$62.31	$220.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.55 / $23.57 / $43.00	Professional	TC	$15.55	$23.57	$43.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $40.25 / $80.98	Professional		$31.57	$40.25	$80.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.05 / $27.17 / $51.24	Professional	26	$21.05	$27.17	$51.24
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $7.91 / $10.29 / $36.03	Professional	52	$7.91	$10.29	$36.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.25 / $20.42 / $42.99	Professional	TC	$17.25	$20.42	$42.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $86.59	Facility	26	$32.40	$32.40	$86.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.57 / $59.57 / $103.77	Professional		$36.57	$59.57	$103.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.51 / $33.36 / $58.99	Professional	26	$20.51	$33.36	$58.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.05 / $27.17 / $49.20	Professional	TC	$16.05	$27.17	$49.20
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $37.26 / $37.26 / $37.26	Facility	26	$37.26	$37.26	$37.26
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $37.06 / $63.31 / $88.87	Professional		$37.06	$63.31	$88.87
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $20.39 / $34.85 / $48.91	Professional	26	$20.39	$34.85	$48.91
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $16.42 / $28.46 / $39.95	Professional	TC	$16.42	$28.46	$39.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.23 / $44.96 / $83.97	Professional		$25.23	$44.96	$83.97
United Facility/Professional Professional Modifier Low / Median / High Price $42.53 / $54.60 / $99.86	Professional		$42.53	$54.60	$99.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.01 / $28.30 / $55.18	Professional	26	$23.01	$28.30	$55.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.98 / $23.45 / $43.25	Professional	TC	$18.98	$23.45	$43.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $33.04 / $33.04 / $33.04	Professional		$33.04	$33.04	$33.04
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $17.79 / $17.79 / $17.79	Professional	26	$17.79	$17.79	$17.79
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $15.25 / $15.25 / $15.25	Professional	TC	$15.25	$15.25	$15.25