Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.88 / $49.88 / $79.86	Facility		$49.88	$49.88	$79.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.87 / $29.87 / $29.87	Facility	26	$29.87	$29.87	$29.87
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $79.86 / $79.86 / $87.41	Facility	TC	$79.86	$79.86	$87.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.44 / $36.14 / $97.15	Professional		$27.44	$36.14	$97.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.53 / $12.34 / $65.58	Professional	26	$7.53	$12.34	$65.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.77 / $29.08 / $46.06	Professional	TC	$19.77	$29.08	$46.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.84 / $36.42 / $49.20	Professional		$19.84	$36.42	$49.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.32 / $12.74 / $17.77	Professional	26	$5.32	$12.74	$17.77
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.53 / $14.53 / $27.11	Professional	TC	$14.53	$14.53	$27.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.62 / $35.03 / $74.88	Professional		$20.62	$35.03	$74.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.57 / $10.08 / $18.82	Professional	26	$5.57	$10.08	$18.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.06 / $25.68 / $58.73	Professional	TC	$15.06	$25.68	$58.73
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $36.14 / $44.92 / $64.53	Professional		$36.14	$44.92	$64.53
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $8.10 / $12.82 / $20.47	Professional	26	$8.10	$12.82	$20.47
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $25.11 / $34.70 / $44.93	Professional	TC	$25.11	$34.70	$44.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.82 / $36.39 / $49.02	Professional		$25.82	$36.39	$49.02
United Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $34.56 / $118.48	Professional		$20.42	$34.56	$118.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.51 / $7.12 / $27.68	Professional	26	$5.51	$7.12	$27.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.69 / $25.75 / $71.25	Professional	TC	$13.69	$25.75	$71.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $14.71 / $32.68 / $32.68	Professional		$14.71	$32.68	$32.68
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $3.79 / $8.43 / $8.43	Professional	26	$3.79	$8.43	$8.43
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $10.91 / $24.25 / $24.25	Professional	TC	$10.91	$24.25	$24.25