Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $22.91	Facility		$19.95	$19.95	$22.91
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $34.67 / $34.67	Facility	26	$34.67	$34.67	$34.67
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.39 / $22.39 / $22.91	Facility	TC	$22.39	$22.39	$22.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $19.05 / $77.62	Professional		$13.80	$19.05	$77.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $25.12 / $81.28	Professional	26	$8.91	$25.12	$81.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.01 / $7.08 / $19.95	Professional	TC	$5.01	$7.08	$19.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $12.30 / $20.42	Professional		$9.77	$12.30	$20.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $12.88 / $19.05	Professional	26	$5.75	$12.88	$19.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $20.89 / $20.89	Facility		$20.89	$20.89	$20.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $16.60 / $33.11	Professional		$10.23	$16.60	$33.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.23 / $19.95	Professional	26	$6.03	$10.23	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.89 / $6.03 / $13.18	Professional	TC	$3.89	$6.03	$13.18
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $19.50 / $33.88	Professional		$13.80	$19.50	$33.88
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.80 / $22.39	Professional	26	$8.91	$13.80	$22.39
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $3.80 / $5.62 / $11.22	Professional	TC	$3.80	$5.62	$11.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $32.36 / $33.11	Professional		$9.77	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $3.39 / $7.24 / $18.20	Facility		$3.39	$7.24	$18.20
United Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $13.49 / $51.29	Professional		$10.23	$13.49	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $7.94 / $30.20	Professional	26	$6.03	$7.94	$30.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.80 / $5.37 / $18.20	Professional	TC	$3.80	$5.37	$18.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $7.08 / $15.49 / $15.49	Professional		$7.08	$15.49	$15.49
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.17 / $9.12 / $9.12	Professional	26	$4.17	$9.12	$9.12
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $2.88 / $6.31 / $6.31	Professional	TC	$2.88	$6.31	$6.31