Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.86 / $941.10 / $1,086.31	Facility		$79.86	$941.10	$1,086.31
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.60 / $99.60 / $99.60	Facility	26	$99.60	$99.60	$99.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $87.41 / $87.41 / $983.94	Facility	TC	$87.41	$87.41	$983.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.39 / $76.58 / $272.85	Professional		$50.39	$76.58	$272.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.74 / $69.94 / $469.11	Professional	26	$27.74	$69.94	$469.11
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.23 / $28.22 / $46.03	Professional	52	$22.23	$28.22	$46.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.58 / $35.79 / $98.76	Professional	TC	$22.58	$35.79	$98.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.53 / $35.86 / $83.72	Professional		$32.53	$35.86	$83.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $22.51 / $60.48	Professional	26	$13.00	$22.51	$60.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.35 / $24.53 / $33.71	Professional	TC	$16.35	$24.53	$33.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.70 / $67.27 / $128.69	Professional		$34.70	$67.27	$128.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.29 / $33.04 / $61.68	Professional	26	$18.29	$33.04	$61.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.64 / $30.24 / $73.73	Professional	TC	$16.64	$30.24	$73.73
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $61.35 / $80.97 / $189.44	Professional		$61.35	$80.97	$189.44
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $26.51 / $41.36 / $51.70	Professional	26	$26.51	$41.36	$51.70
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $32.70 / $42.07 / $119.44	Professional	TC	$32.70	$42.07	$119.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.24 / $45.79 / $83.59	Professional		$30.24	$45.79	$83.59
United Facility/Professional Professional Modifier Low / Median / High Price $32.82 / $57.86 / $199.13	Professional		$32.82	$57.86	$199.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.87 / $23.73 / $93.92	Professional	26	$17.87	$23.73	$93.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.67 / $28.48 / $68.38	Professional	TC	$14.67	$28.48	$68.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.70 / $54.89 / $54.89	Professional		$24.70	$54.89	$54.89
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $12.41 / $27.57 / $27.57	Professional	26	$12.41	$27.57	$27.57
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $12.29 / $27.32 / $27.32	Professional	TC	$12.29	$27.32	$27.32