Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $200.00 / $414.00	Facility		$90.00	$200.00	$414.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.73 / $69.73 / $69.73	Facility	26	$69.73	$69.73	$69.73
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $157.35 / $276.00 / $885.55	Facility	TC	$157.35	$276.00	$885.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.70 / $73.65 / $323.64	Professional		$51.70	$73.65	$323.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.60 / $56.02 / $466.43	Professional	26	$17.60	$56.02	$466.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.65 / $46.70 / $176.76	Professional	TC	$28.65	$46.70	$176.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.91 / $59.51 / $105.75	Professional		$43.91	$59.51	$105.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $19.64 / $43.02	Professional	26	$12.88	$19.64	$43.02
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $31.47 / $47.21 / $48.96	Professional	TC	$31.47	$47.21	$48.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.15 / $69.84 / $136.22	Professional		$34.15	$69.84	$136.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.16 / $21.98 / $43.39	Professional	26	$11.16	$21.98	$43.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.69 / $45.78 / $93.66	Professional	TC	$23.69	$45.78	$93.66
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $40.61 / $72.54 / $112.39	Professional		$40.61	$72.54	$112.39
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $13.03 / $23.26 / $37.04	Professional	26	$13.03	$23.26	$37.04
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $27.60 / $49.29 / $75.87	Professional	TC	$27.60	$49.29	$75.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.24 / $81.58 / $125.95	Professional		$41.24	$81.58	$125.95
United Facility/Professional Professional Modifier Low / Median / High Price $37.88 / $54.22 / $188.38	Professional		$37.88	$54.22	$188.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.46 / $17.55 / $59.78	Professional	26	$12.46	$17.55	$59.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.42 / $36.67 / $130.88	Professional	TC	$25.42	$36.67	$130.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $31.43 / $69.84 / $69.84	Professional		$31.43	$69.84	$69.84
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.92 / $19.82 / $19.82	Professional	26	$8.92	$19.82	$19.82
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.51 / $50.02 / $50.02	Professional	TC	$22.51	$50.02	$50.02