Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $23.44 / $67.61	Facility		$23.44	$23.44	$67.61
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $19.95 / $19.95	Facility	26	$19.95	$19.95	$19.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $38.90 / $114.82	Professional		$21.38	$38.90	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $15.14 / $50.12	Professional	26	$5.01	$15.14	$50.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $25.12 / $56.23	Professional	TC	$15.85	$25.12	$56.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $19.95 / $23.44	Professional		$15.49	$19.95	$23.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.39 / $9.33 / $12.88	Professional	26	$3.39	$9.33	$12.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Facility		$53.70	$53.70	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $25.70 / $61.66	Professional		$15.49	$25.70	$61.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.39 / $5.75 / $11.75	Professional	26	$3.39	$5.75	$11.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $19.95 / $48.98	Professional	TC	$12.02	$19.95	$48.98
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $43.65 / $87.10	Professional		$35.48	$43.65	$87.10
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $8.13 / $12.59	Professional	26	$5.01	$8.13	$12.59
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $33.11 / $74.13	Professional	TC	$24.55	$33.11	$74.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $32.36 / $36.31	Professional		$9.33	$32.36	$36.31
United Facility/Professional Facility Modifier Low / Median / High Price $2.69 / $10.96 / $25.12	Facility		$2.69	$10.96	$25.12
United Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $26.30 / $79.43	Professional		$15.14	$26.30	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.39 / $4.47 / $17.38	Professional	26	$3.39	$4.47	$17.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $20.42 / $57.54	Professional	TC	$12.02	$20.42	$57.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $25.70 / $25.70	Professional		$11.48	$25.70	$25.70
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $2.29 / $5.13 / $5.13	Professional	26	$2.29	$5.13	$5.13
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $9.12 / $20.42 / $20.42	Professional	TC	$9.12	$20.42	$20.42