Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $216.00 / $270.00 / $359.84	Facility		$216.00	$270.00	$359.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.61 / $31.61 / $31.61	Facility	26	$31.61	$31.61	$31.61
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $143.47 / $672.87 / $717.33	Facility	TC	$143.47	$672.87	$717.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.52 / $67.14 / $166.67	Professional		$43.52	$67.14	$166.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.55 / $22.40 / $173.60	Professional	26	$7.55	$22.40	$173.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.13 / $56.69 / $129.96	Professional	TC	$36.13	$56.69	$129.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $39.97 / $93.24	Professional		$36.29	$39.97	$93.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.64 / $13.00 / $18.79	Professional	26	$5.64	$13.00	$18.79
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.15 / $48.25 / $60.16	Professional	TC	$32.15	$48.25	$60.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.10 / $56.83 / $108.48	Professional		$33.10	$56.83	$108.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.95 / $10.36 / $19.12	Professional	26	$5.95	$10.36	$19.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.87 / $46.78 / $89.19	Professional	TC	$27.87	$46.78	$89.19
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $63.81 / $113.41	Professional		$37.20	$63.81	$113.41
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $8.61 / $13.47 / $16.92	Professional	26	$8.61	$13.47	$16.92
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $27.78 / $52.90 / $96.49	Professional	TC	$27.78	$52.90	$96.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.65 / $72.83 / $98.06	Professional		$51.65	$72.83	$98.06
United Facility/Professional Professional Modifier Low / Median / High Price $35.21 / $44.31 / $172.20	Professional		$35.21	$44.31	$172.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.83 / $7.58 / $33.72	Professional	26	$5.83	$7.58	$33.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.59 / $36.76 / $129.19	Professional	TC	$28.59	$36.76	$129.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.26 / $62.80 / $62.80	Professional		$28.26	$62.80	$62.80
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $4.01 / $8.93 / $8.93	Professional	26	$4.01	$8.93	$8.93
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $24.24 / $53.87 / $53.87	Professional	TC	$24.24	$53.87	$53.87