Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.51 / $58.24 / $414.63	Facility		$37.51	$58.24	$414.63
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.11 / $21.11 / $24.04	Facility	26	$21.11	$21.11	$24.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.51 / $58.24 / $122.40	Professional		$37.51	$58.24	$122.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.11 / $29.57 / $64.41	Professional	26	$21.11	$29.57	$64.41
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $326.11 / $326.11 / $334.86	Professional	50	$326.11	$326.11	$334.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $18.76 / $24.15 / $35.57	Professional	52	$18.76	$24.15	$35.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.66 / $22.63 / $76.37	Professional	TC	$15.66	$22.63	$76.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.04 / $59.04 / $59.04	Professional		$59.04	$59.04	$59.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.57 / $84.59 / $222.23	Facility		$52.57	$84.59	$222.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $89.56	Facility	26	$33.84	$33.84	$89.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.44 / $89.72 / $153.75	Professional		$41.44	$89.72	$153.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.86 / $38.21 / $62.80	Professional	26	$25.86	$38.21	$62.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.08 / $52.17 / $94.55	Professional	TC	$15.08	$52.17	$94.55
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $30.98 / $54.87 / $89.70	Professional		$30.98	$54.87	$89.70
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $14.31 / $23.55 / $36.74	Professional	26	$14.31	$23.55	$36.74
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $11.19 / $26.63 / $57.08	Professional	TC	$11.19	$26.63	$57.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.42 / $47.14 / $88.62	Professional		$28.42	$47.14	$88.62
United Facility/Professional Professional Modifier Low / Median / High Price $52.20 / $76.83 / $132.55	Professional		$52.20	$76.83	$132.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.43 / $32.04 / $51.10	Professional	26	$22.43	$32.04	$51.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.67 / $43.16 / $83.79	Professional	TC	$25.67	$43.16	$83.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $36.00 / $36.00 / $36.00	Professional		$36.00	$36.00	$36.00
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.72 / $22.72 / $22.72	Professional	26	$22.72	$22.72	$22.72
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $13.28 / $13.28 / $17.04	Professional	TC	$13.28	$13.28	$17.04