Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $90.00 / $487.40	Facility		$90.00	$90.00	$487.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.40 / $93.40 / $93.40	Facility	26	$93.40	$93.40	$93.40
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $177.84 / $177.84 / $500.46	Facility	TC	$177.84	$177.84	$500.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.92 / $85.58 / $232.05	Professional		$62.92	$85.58	$232.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.92 / $37.83 / $155.24	Professional	26	$23.92	$37.83	$155.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.27 / $53.94 / $113.33	Professional	TC	$35.27	$53.94	$113.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.72 / $54.67 / $124.75	Professional		$50.72	$54.67	$124.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $16.45 / $52.84	Professional	26	$13.00	$16.45	$52.84
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.96 / $53.95 / $67.29	Professional	TC	$35.96	$53.95	$67.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.44 / $83.94 / $157.99	Professional		$47.44	$83.94	$157.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.25 / $31.44 / $63.53	Professional	26	$17.25	$31.44	$63.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.93 / $50.60 / $104.39	Professional	TC	$27.93	$50.60	$104.39
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $54.08 / $89.34 / $156.25	Professional		$54.08	$89.34	$156.25
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $38.86 / $53.12	Professional	26	$30.20	$38.86	$53.12
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $28.92 / $50.64 / $101.27	Professional	TC	$28.92	$50.64	$101.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $86.37 / $166.95	Professional		$41.40	$86.37	$166.95
United Facility/Professional Professional Modifier Low / Median / High Price $48.72 / $62.32 / $214.38	Professional		$48.72	$62.32	$214.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.28 / $25.16 / $101.74	Professional	26	$18.28	$25.16	$101.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.73 / $42.11 / $140.76	Professional	TC	$30.73	$42.11	$140.76
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $38.71 / $86.03 / $86.03	Professional		$38.71	$86.03	$86.03
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.60 / $25.78 / $25.78	Professional	26	$11.60	$25.78	$25.78
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $27.11 / $60.25 / $60.25	Professional	TC	$27.11	$60.25	$60.25