Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $53.70 / $128.82	Facility		$47.86	$53.70	$128.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Facility	26	$74.13	$74.13	$74.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $95.50 / $109.65 / $114.82	Facility	TC	$95.50	$109.65	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $64.57 / $190.55	Professional		$47.86	$64.57	$190.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $36.31 / $213.80	Professional	26	$19.95	$36.31	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $36.31 / $81.28	Professional	TC	$26.92	$36.31	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $40.74 / $47.86	Professional		$31.62	$40.74	$47.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $28.84 / $45.71	Professional	26	$12.88	$28.84	$45.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $23.44 / $24.55	Professional	TC	$18.20	$23.44	$24.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Facility		$141.25	$141.25	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $54.95 / $138.04	Professional		$32.36	$54.95	$138.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $28.84 / $70.79	Professional	26	$13.80	$28.84	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $30.20 / $69.18	Professional	TC	$19.05	$30.20	$69.18
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $95.50 / $181.97	Professional		$66.07	$95.50	$181.97
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $52.48 / $104.71	Professional	26	$25.70	$52.48	$104.71
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $52.48 / $79.43	Professional	TC	$31.62	$52.48	$79.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $33.11 / $58.88	Professional		$31.62	$33.11	$58.88
United Facility/Professional Facility Modifier Low / Median / High Price $10.96 / $21.88 / $54.95	Facility		$10.96	$21.88	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $58.88 / $181.97	Professional		$30.90	$58.88	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $25.70 / $79.43	Professional	26	$13.18	$25.70	$79.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $27.54 / $91.20	Professional	TC	$18.62	$27.54	$91.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $51.29 / $51.29	Professional		$23.44	$51.29	$51.29
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $20.42 / $20.42	Professional	26	$9.12	$20.42	$20.42
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $31.62 / $31.62	Professional	TC	$14.13	$31.62	$31.62